Writing helps Chinese breast cancer survivors cope: study

Chinese survivors of breast cancer have a better chance of improving their health if they write about their fears and emotions, a new study from the University of Houston suggests.

The study, published in Health Psychology, showed that recovering patients who wrote about how they felt for 20 to 30 minutes a day three to four days a week for three consecutive weeks had improved immune function.

The "release offered by writing had a direct impact on the body's capacity to withstand stress and fight off infection and disease", the report said.

"Cancer patients, like war veterans in Iraq, can experience post-traumatic stress symptoms," said Qian Lu, assistant professor and director of the Culture and Health Research Center at the University of Houston.

"Many times when cancer patients get diagnosed, they face lots of emotional trauma," Lu said. "There's a sense of loss, depression, anxiety about going into treatment and how they are going to face the future. They have a lot of emotional events going on in their life."

A total of 19 cancer survivors in the Los Angeles area participated in the study. Those within five years post-breast cancer diagnosis and who said they were comfortable speaking and writing in Chinese — either Mandarin or Cantonese.

All participants answered health assessment questionnaires prior to the study and then were given three sets of instructions: In the first week, they were asked to write about their deepest thoughts on their experience with breast cancer. In the second week, they wrote about their coping strategies in dealing with cancer-related stressors. In the third, they wrote about their positive thoughts and feelings regarding their experience with breast cancer.

The aim of the writing was "to facilitate emotional disclosure, effective coping, and finding benefit, which would work together to bring stressors and personal goals into awareness and regulate thoughts and emotions relevant to the cancer experience", the report said.

Participants answered questionnaires three and six months after completing the writing assignments. Phone interviews were conducted after the six-month follow-up as well. Researchers assessed participants' quality of life, levels of fatigue, physical symptoms, thoughts and mood. The results suggested that expressive writing was associated with positive health outcomes, though the researchers acknowledged that one group of participants "did not allow for causal inferences".

Lu told China Daily that her team was designing a larger scale study that will involve more Asian-American women — not just Chinese.

Lu said that she initially wanted to do this study because there weren't similar studies done with many ethnic groups of women — the only one she had seen was with non-Hispanic white women.

In addition, Chinese women had "a dramatic difference in attitudes" towards cancer than their white counterparts, thus the need to study the community more closely, Lu explained.

"The Chinese-speaking breast cancer survivors are very reluctant to talk about their cancer. They don't want to tell their friends, or sometimes even family members, that they have breast cancer. They feel stigmatized," she said.

"When the Chinese are first diagnosed with breast cancer, they immediately think, ‘I'm going to die'. On the other hand, statistics show that long-term recovery for breast cancer is pretty good," said Lu.

"So the knowledge is largely there for the Caucasian population, but with the Chinese population, their knowledge is limited, and that determines the attitude where they feel that the cancer is very threatening, and they associate it with immediate death. They stigmatize it, thinking it might be infectious, that they may bring bad luck to other people."

amyhe@chinadailyusa.com