Expressive Writing for Young Cancer Survivors

Overseen By Qian Lu, MD,PHD

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: M.D. Anderson Cancer Center

Disqualifiers: Nonmelanoma skin cancer, major mental health disorder, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

30 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how group-based expressive writing can help young cancer survivors improve their quality of life. Participants will write about their cancer journey for 20 minutes each week over four weeks. The trial seeks survivors diagnosed 1 to 5 years ago who can communicate in English. Participants must have internet access for the virtual sessions.

As an unphased trial, this study offers a unique opportunity for participants to contribute to understanding how expressive writing can enhance well-being.

Will I have to stop taking my current medications?

The trial does not specify whether you need to stop taking your current medications. However, participants receiving maintenance therapy are still eligible, so you may be able to continue some treatments.

What prior data suggests that this writing intervention is safe for young cancer survivors?

Research has shown that participants have positively received expressive writing activities. Studies with older adult cancer survivors and healthy young adults have found that these activities can improve health without causing serious side effects. Typically, these activities involve writing about personal experiences, which many find helpful.

For the virtual, group-based expressive writing program under study, previous trials have assessed its practicality and acceptability. So far, no major safety issues or negative effects have been reported, suggesting that the program is generally well-tolerated. Since the treatment involves writing about personal experiences, it is considered low risk. However, if there are any concerns, discussing them with the study team is advisable. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Expressive Writing intervention because it offers a fresh, non-medical approach to supporting young cancer survivors, targeting emotional and psychological well-being. Unlike standard treatments that primarily focus on physical health, such as chemotherapy or radiation, this method encourages participants to process their cancer experiences through structured writing. This virtual, group-based approach is unique because it provides a safe space for survivors to share and reflect without the constraints of traditional therapy sessions, potentially benefiting their mental health in a convenient, accessible format.

What evidence suggests that this writing intervention could improve quality of life for young cancer survivors?

Research has shown that writing about thoughts and feelings can positively affect health for both older adults who have survived cancer and healthy young adults. In past studies, participants who engaged in this writing reported improved mood and overall well-being. This practice helps individuals understand and manage their emotions, enhancing mental health. In this trial, participants will take part in a virtual, group-based expressive writing intervention. Although this virtual group setting is a new approach, early results suggest it is effective and well-received. This method aims to improve the quality of life for young cancer survivors by providing a supportive space to share and reflect on their cancer experiences. ^{1 2 3 6 7}

Who Is on the Research Team?

Qian Lu, MD

Principal Investigator

M.D. Anderson Cancer Center

Are You a Good Fit for This Trial?

This trial is for English-speaking cancer survivors aged 18-39, who were diagnosed with stage II-IV cancer between ages 15-39 and are within 5 years post-treatment. Participants should have no current evidence of disease and internet access. Those with major mental health disorders or nonmelanoma skin cancer cannot join.

Inclusion Criteria

My cancer is currently not detectable.

My cancer was diagnosed as stage II-IV within the last 5 years.

Can speak, read, and write in English

Exclusion Criteria

I have been diagnosed with a type of skin cancer that is not melanoma.

Major mental health disorder (e.g., schizophrenia or bipolar disorder [determined from patient records or self-disclosure])

No internet access

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants engage in a virtual, group-based expressive writing intervention for 4 weeks

4 weeks

Weekly virtual sessions

Follow-up

Participants complete questionnaires about mood, health, and demographic information at baseline, and 1- and 3-month follow-up

3 months

3 virtual assessments

What Are the Treatments Tested in This Trial?

Interventions

• Virtual, Group-Based, Expressive Writing Intervention

Trial Overview

The study explores a virtual group-based expressive writing intervention aimed at improving the quality of life for young adult cancer survivors. It involves participants from different age groups (18-25, 26-39) sharing their experiences through guided writing sessions.

How Is the Trial Designed?

Group I: Young adults (ages 26-39 years) Experimental Treatment 1 Intervention

Participants complete questionnaires over 20 minutes about their mood, health, and demographic information at baseline, and 1, and 3 months. Participants are asked to write about their cancer experiences over 20 minutes (non-stop) for 4 weeks.

Group II: General group (ages 18-39 years) Experimental Treatment 1 Intervention

Participants complete questionnaires over 20 minutes about their mood, health, and demographic information at baseline, and 1, and 3 months. Participants are asked to write about their cancer experiences over 20 minutes (non-stop) for 4 weeks.

Group III: Emerging adults (ages18-25 years) Experimental Treatment 1 Intervention

Participants complete questionnaires over 20 minutes about their mood, health, and demographic information at baseline, and 1, and 3 months. Participants are asked to write about their cancer experiences over 20 minutes (non-stop) for 4 weeks.

Who Is Running the Clinical Trial?

M.D. Anderson Cancer Center

Lead Sponsor

Trials

3,107

Recruited

1,813,000+

National Cancer Institute (NCI)

Collaborator

Trials

14,080

Recruited

41,180,000+

Published Research Related to This Trial

Expressive writing (EW) interventions showed a small but significant effect in relieving cancer symptoms among 1,718 patients, based on a meta-analysis of 14 trials.

While EW did not significantly improve psychological and cognitive outcomes, it did enhance health-related quality of life compared to usual care, suggesting potential benefits that may require further investigation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effects of Expressive Writing Interventions for Patients With Cancer: A Meta-Analysis. Oh, PJ., Kim, SH.[2017]

Talking and writing about their cancer experience can significantly help pediatric patients and survivors by improving their understanding of their condition and reducing symptoms like depression and anxiety.

Expressive writing, video narratives, and bibliotherapy are effective and accessible therapeutic methods that can enhance the quality of life for young cancer patients, and further research is encouraged to explore these benefits more deeply.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Utility of Verbal Therapy for Pediatric Cancer Patients and Survivors: Expressive Writing, Video Narratives, and Bibliotherapy Exercises. Jones, JK., Evans, JF., Barfield, RC.[2021]

Facilitated writing activities led by a writing coach were found to be feasible and acceptable for patients with advanced incurable cancer, with 82% of participants completing at least three months of the intervention.

The study reported no increase in anxiety or depression among participants, and most patients expressed a desire for the intervention to continue, indicating a positive reception of the writing activities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Getting Creative: Pilot Study of a Coached Writing Intervention in Patients with Advanced Cancer at a Rural Academic Medical Center. Vergo, MT., Klassen-Landis, M., Li, Z., et al.[2022]

A systematic review of 16 randomized controlled trials involving cancer patients and survivors found no significant overall benefits of expressive writing intervention (EWI) on psychological or physical health outcomes.

While EWI did not show general effectiveness, there may be potential benefits for individuals with low emotional support, suggesting that future research should explore specific subgroups that might respond better to this intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of expressive writing intervention on psychological and physical health outcomes in cancer patients--a systematic review and meta-analysis. Zachariae, R., O'Toole, MS.[2022]

A study involving 90 Chinese breast cancer survivors showed that expressive writing interventions, particularly writing about cancer facts, significantly improved quality of life (QOL) compared to writing about stress and coping efforts.

Writing about positive aspects of the cancer experience also improved QOL, but not as effectively as writing about cancer facts, indicating that both approaches can be beneficial for patients undergoing chemotherapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The impact of an expressive writing intervention on quality of life among Chinese breast cancer patients undergoing chemotherapy. Lu, Q., Dong, L., Wu, IHC., et al.[2022]

Expressive writing (EW) significantly reduces negative somatic symptoms in breast cancer patients within a 3-month follow-up period, based on a meta-analysis of 11 randomized controlled trials involving 1,178 participants.

However, EW does not show a significant impact on psychological health outcomes at any follow-up time, indicating that while it may help with physical symptoms, its benefits may be limited and short-lived.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of Expressive Writing Intervention on Health Outcomes in Breast Cancer Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Zhou, C., Wu, Y., An, S., et al.[2023]

The WISE trial is a randomized controlled study designed to evaluate the efficacy of a brief psychological intervention called expressive helping for adult hematological cancer patients undergoing hematopoietic stem cell transplant, aiming to reduce physical and psychological symptoms during and after the transplant process.

Expressive helping combines emotionally expressive writing and peer support, and is expected to improve health-related quality of life and reduce distress and fatigue, potentially preventing long-term survivorship issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of expressive helping in adult hematologic cancer patients undergoing stem cell transplant: protocol for the Writing for Insight, Strength, and Ease (WISE) study's two-arm randomized controlled trial. Whitmore, L., Schulte, T., Bovbjerg, K., et al.[2021]

Expressive writing, involving four 20-minute sessions focused on emotional disclosure, significantly improved the quality of life for breast cancer patients undergoing chemotherapy, with noticeable effects observed two weeks after the intervention.

The study, which included 82 participants, also indicated that expressive writing positively influenced self-care self-efficacy over time, suggesting it is a beneficial and low-cost psychological intervention for patients lacking emotional support.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Structured Expressive Writing on Quality of Life and Perceived Self-Care Self-Efficacy of Breast Cancer Patients Undergoing Chemotherapy in Central China: A Randomized Controlled Trial. Wang, R., Li, L., Xu, J., et al.[2023]

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