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Do cancer curvivors and metavivors have distinct needs for stress management intervention? Retrospective analysis of a mind–body survivorship program

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Abstract

Purpose

Cancer “curvivors” (completed initial curative intent treatment with surgery, radiation, chemotherapy, and/or other novel therapies) and “metavivors” (living with metastatic or chronic, incurable cancer) experience unique stressors, but it remains unknown whether these differences impact benefits from mind–body interventions. This study explored differences between curvivors and metavivors in distress (depression, anxiety, worry) and resiliency changes over the course of an 8-week group program, based in mind–body stress reduction, cognitive-behavioral therapy (CBT), and positive psychology.

Methods

From 2017–2021, 192 cancer survivors (83% curvivors; 17% metavivors) completed optional online surveys of resiliency (CES) and distress (PHQ-8, GAD-7, PSWQ-3) pre- and post- participation in an established clinical program. Mixed effect regression models explored curvivor-metavivor differences at baseline and in pre-post change.

Results

Compared to curvivors, metavivors began the program with significantly more resilient health behaviors (B = 0.99, 95% CI[0.12, 1.86], p = .03) and less depression (B = −2.42, 95%CI[−4.73, −0.12], p = .04), with no other significant differences. Curvivors experienced significantly greater reductions in depression (curvivor-metavivor difference in strength of change = 2.12, 95% CI [0.39, 3.83], p = .02) over the course of the program, with no other significant differences. Neither virtual delivery modality nor proportion of sessions attended significantly moderated strength of resiliency or distress change.

Conclusion

Metavivors entering this mind–body program had relatively higher well-being than did curvivors, and both groups experienced statistically comparable change in all domains other than depression. Resiliency programming may thus benefit a variety of cancer survivors, including those living with incurable cancer.

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Data availability

The data analyzed for the current study are available from the corresponding author on reasonable request with ethics board approval.

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Acknowledgements

We thank the program participants for their contributions to this research. We also thank April Hirschberg, MD for her work leading clinical groups together with Giselle Perez, PhD, Lara Traeger, PhD, and Elyse Park, PhD, MPH and thank Allyson Foor for assistance with coordination of this clinical program.

Funding

Dr. Finkelstein-Fox’s effort is supported by T32CA092203. Dr. Hall’s effort is supported by K23AT010157. Dr. Perez’s effort is supported by K07CA211955.

Author information

Authors and Affiliations

  1. Department of Psychiatry, Massachusetts General Hospital, 100 Cambridge St., Suite 1600, Boston, MA, 02114, USA

    Lucy Finkelstein-Fox, Cayley C. Bliss, Autumn W. Rasmussen, Daniel L. Hall, Giselle K. Perez, Lara N. Traeger, Reid Anctil, Elise Noonan & Elyse R. Park

  2. Health Promotion and Resiliency Intervention Research (HPRIR) Program, Massachusetts General Hospital, Boston, MA, USA

    Lucy Finkelstein-Fox, Cayley C. Bliss, Autumn W. Rasmussen, Daniel L. Hall, Giselle K. Perez, Lara N. Traeger, Reid Anctil, Elise Noonan & Elyse R. Park

  3. Department of Psychiatry, Harvard Medical School, Boston, MA, USA

    Lucy Finkelstein-Fox, Daniel L. Hall, Giselle K. Perez, Lara N. Traeger & Elyse R. Park

  4. Department of Psychology, University of Miami, Coral Gables, FL, USA

    Areej El-Jawahri & Lara N. Traeger

  5. Massachusetts General Hospital Cancer Center, Boston, MA, USA

    Areej El-Jawahri, Amy H. Comander & Jeffrey Peppercorn

  6. Department of Medicine, Harvard Medical School, Boston, MA, USA

    Amy H. Comander, Jeffrey Peppercorn & Elyse R. Park

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  1. Lucy Finkelstein-Fox
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  2. Cayley C. Bliss
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  3. Autumn W. Rasmussen
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  4. Daniel L. Hall
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  5. Areej El-Jawahri
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Contributions

Finkelstein-Fox – Conception and design, data collection and assembly, data analysis and interpretation, writing, final approval. Bliss – Conception and design, data collection and assembly, writing, final approval. Rasmussen—Conception and design, data collection and assembly, writing, final approval. Hall—Conception and design, data collection and assembly, writing, final approval. El-Jawahri—Conception and design, writing, final approval. Perez—Conception and design, providing study materials, data collection and assembly, writing, final approval. Traeger—Conception and design, providing study materials, data collection and assembly, writing, final approval. Comander- Conception and design, data collection and assembly, data analysis and interpretation, writing, final approval. Peppercorn- Conception and design, writing, final approval. Anctil- Conception and design, data collection and assembly, writing, final approval. Noonan- Conception and design, writing, final approval. Park- Conception and design, providing study materials, data collection and assembly, data analysis and interpretation, writing, final approval.

Corresponding author

Correspondence to Lucy Finkelstein-Fox.

Ethics declarations

Ethics approval

Study procedures were approved by the Mass General Brigham IRB (Protocol #2011P001081). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Competing interests

The authors declare no competing interests.

Conflicts of interest

The authors have no relevant financial or non-financial interests.

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Finkelstein-Fox, L., Bliss, C.C., Rasmussen, A.W. et al. Do cancer curvivors and metavivors have distinct needs for stress management intervention? Retrospective analysis of a mind–body survivorship program. Support Care Cancer 31, 616 (2023). https://doi.org/10.1007/s00520-023-08062-1

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