Expressive Writing Reduced Cancer-Related Symptoms in RCC Patients

Expressive writing is a brief and simple intervention that a recent study showed helped to reduce cancer-related symptoms and improved physical functioning in patients with renal cell carcinoma.

Considering the findings in light of an entirely self-administered, brief, safe, and virtually no-cost intervention, expressive writing appears to be a promising supportive care approach, according to study author Lorenzo Cohen, MD, of the University of Texas MD Anderson Cancer Center.

“Just four 20-minute sessions of expressive writing, writing about your deepest thoughts and feelings about a past traumatic event or an ongoing difficult life experience like the diagnosis and treatment of cancer, has been found to improve a diverse set of outcomes in both healthy people and those with cancer,” Cohen told Cancer Network.

Although prior studies with cancer patients have tended to be small and mainly conducted in women with breast cancer with early-stage disease, this study sought to determine the benefits of expressive writing in patients with kidney cancer, half of whom had advanced disease.

Cohen and colleagues enrolled 277 patients with stage I to stage IV renal cell carcinoma. Patients were randomly assigned to expressive writing or neutral writing-writing about neutral topics-on four occasions. At baseline and months 1, 4, and 10, the patients were tested for depression, fatigue, cancer-related symptoms, sleep, and other quality-of-life parameters using several different scales. Results of the study were published in the Journal of Clinical Oncology.

“Patients in the expressive writing group reported fewer cancer-related symptoms, moderately lower levels of fatigue, and higher physical function aspects of quality of life 10 months after the writing sessions compared to patients that were in a neutral writing group,” Cohen said.

Specifically, at 10 months the group assigned expressive writing had significantly better MD Anderson Symptoms Inventory scores compared with those assigned neutral writing (P = .003). Additionally, expressive writing resulted in higher physical component summary scores on the Medical Outcomes Study Short Form-36 at 10 months (P = .019).

“These beneficial effects were partly due to the expressive writing leading to lower intrusive thoughts (unbidden/unwanted thoughts about their cancer intruding in their lives) one month post-intervention,” Cohen said. “It was surprising to see that the effects emerged over time, as one would expect the effects of such a brief intervention to wane over time. However, it seems that expressive writing leads to better long-term outcomes through early improvements in cognitive processing.”

According to the researchers, future research should examine for whom expressive writing is most useful.