PHASE II STUDY OF PSYCHOTHERAPEUTIC INTERVENTION IN ADVANCED CANCER MARCO J.DE VRIES, JOHANNESN.SCHILDER, CORNELISL.MULDER, ADRIANA M.E.VRANCKEN, MARGOTE.REMIE and BERTGARSSEN* The Helen Dowling Institute for Biopsychosocial Medicine, PO Box 25309, 3001HH Rotterdam, The Netherlands SUMMARY The effect of psychosocial counseling on tumor progression was studied in 96 cancer patients, who were no longer amenable to regular medical treatment. Patients were offered 12 session of individual experiential-existential counseling, each sessions lasting 1.5 to 2 hours. In addition patients participated fortnightly in group counseling meetings. In five out of 35 evaluable patients, tumor growth became stationary during or immediately following therapy. In four patients this stationary period last 3–9 months, and in one patient 2 years. Natural Killer cell activity, self-reported loneliness, depression, purpose in life and locus of control showed no change from pre- to post intervention. © 1997 by John Wiley & Sons, Ltd. Psycho-Oncology 6: 129–137, 1997. No. of Figures: 1. No. of Tables: 4. No. of Refs: 42. INTRODUCTION Several studies have found an effect of psychoso- cial counseling on progression of cancer. Two prospective, randomized studies have shown that group counseling may prolong survival of cancer patients (Spiegel et al., 1989; Fawzy et al., 1993). Richardson et al. (1990a), in a randomized, controlled study observed an association between patient education and improved survival, also when controling for improved compliance. How- ever, a prospective, randomized study using indi- vidual counseling in late-stage patients with dif- ferent types of cancer has been negative (Linn et al., 1982). This negative finding may be due to the relatively short follow-up period of 12 months. Spiegel et al. found no differences in survival until 18 months from study entry in their breast cancer patients. Also, in the study of Fawzy et al., no differences in survival were apparent in the first 15 months from study entry. Finally, in one study using matched controls no effect on survival of a particular type of support groups (so-called exceptional cancer patients (ECaP) groups) was found (Gellert et al., 1993). The purpose of the present study, which started in 1987, before the results of the study by Spiegel et al. were known, was to investigate in a phase II study the effects of a psychosocial counseling program on progression of advanced cancer. The program was a combination of the existential (Yalom, 1980; Spiegel and Bloom, 1983; Spiegel and Spira, 1991) and the experiential approach (Coughlan and Klein, 1984). Components of the program were also chosen on the basis of earlier studies on spontaneous regression of cancer (SRC). Through qualitative analysis of interviews with SRC patients, it was found that these patients had shown shifts towards personal autonomy, experiencing purpose in life and more extensive and/or higher quality of experienced social rela- tionships (de Vries, 1986; Van Baalen et al., 1987) and underwent experiences and performed activ- ities that were essential for them, prior to the first signs of clinical improvement (Schilder, 1992). Trying to help patients to experience their needs, and to realize their aims and potentials in life was *Correspondence to: Bert Garssen. Contract grant sponsor: The Josephine Nefkens Foundation. PSYCHO -ONCOLOGY , VOL. 6: 129–137 (1997) CCC 1057–9249/97/020129–09 $17.50 © 1997 by John Wiley & Sons, Ltd. A ccepted 8 November 1996