Efficacy of two psychological interventions on pain, distress, and post-traumatic growth in breast cancer survivors: A 2-year follow-up of two randomized controlled trials.

PURPOSE: This study investigated the 1- and 2-year efficacy of two brief interventions, Mindfulness-integrated Cognitive Behavioral Therapy (MiCBT) and an Observational Learning and Acceptance-based pain management program (POLA), compared to Treatment-As-Usual (TAU), on pain, psychological distress, and post-traumatic growth (PTG).

METHODS: BC survivors (n = 54) who had participated in two randomized controlled trials during primary treatment were followed up to 2 years post-diagnosis. Participants were assigned to MiCBT, POLA, or TAU. Outcome measures (pain, psychological distress, depression, anxiety, stress, PTG) were assessed at baseline, 1-year, and 2-year follow-ups.

RESULTS: The control group exhibited persistent morbidity, with high rates of moderate-to-severe symptoms across both follow-ups (e.g., pain: 44 % at 1-year, 33 % at 2-years; anxiety: 32 % at 1-year, 39 % at 2-years). Both interventions demonstrated significant but time-dependent benefits. While pain reduction was significant only at 1-year for both groups, MiCBT showed broader psychological efficacy, reducing depression and psychological distress at 1-year and maintaining anxiety reduction across both follow-ups. POLA significantly reduced anxiety at 1-year follow-up. Both interventions produced sustained improvements in stress and PTG across all assessments.

CONCLUSION: The findings suggest that providing psychological interventions during chemotherapy is associated with significant long-term benefits, with specific advantages varying by the type of intervention. In contrast, the control group exhibited persistent symptoms across both follow-up periods. These results support the integration of targeted psychological support into standard oncology care to address the long-term needs of survivors.