News | 15 October 2020

Cognitive behavioural therapy for pain after breast cancer surgery

Study receives half a million euros in funding from the Dutch Cancer Society

Medical specialists at Maastricht UMC+ will collaborate with the Faculty of Psychology and Neuroscience at Maastricht University to investigate whether cognitive behavioural therapy can help prevent persistent pain after breast cancer treatment, a problem that affects about four out of ten patients. The Maastricht research team has received over half a million euros in funding from the Dutch Cancer Society/Pink Ribbon and the European Society of Anaesthesiology (ESA) to investigate the problem.

LogoSome 12,000 women in the Netherlands are diagnosed with breast cancer every year. Advances in diagnostics and treatment mean that the five-year survival rate is now around 90%. While this is obviously good news for patients, lingering physical and psychological complaints after treatment are not uncommon. Chronic pain following breast cancer surgery is particularly common, affecting some 40% of patients. Chronic pain not only slows recovery but also diminishes the patient's quality of life and ability to re-enter the workforce, even years later.

Psychological aspects
There are almost no effective treatments to reduce chronic pain after breast cancer surgery. Previous research has shown that patients who are extremely anxious about surgery and have strong negative thoughts about pain are more likely to suffer persistent pain. The Maastricht team's study therefore aims to prevent chronic pain by better preparing vulnerable patients mentally for their surgery. The team is developing an online programme of cognitive behavioural therapy meant specifically to boost the mental resilience of breast cancer patients. The online programme will be combined with individual (online) counselling by a psycho-oncologist.

Behavioural therapy
From January 2021, any patient undergoing breast cancer surgery will be eligible to participate in the programme. Potential participants will fill in an online questionnaire designed to identify those who have an increased risk of pain after treatment. The women at risk will then be divided into two groups. One group will receive behavioural therapy. The other is a control group that will be given information and lifestyle advice. Both groups will attend five online sessions and have three online conversations with a therapist over a six-week period before and after breast cancer surgery. Ultimately, the success of the therapy must be demonstrated by a decline in the number of patients with chronic pain.

The effectiveness of cognitive behavioural therapy for patients undergoing breast cancer surgery is being examined in the AMAZONE study. Several Dutch hospitals specialising in breast cancer are taking part in the research, which is headed by Maastricht UMC+ and Maastricht University's Faculty of Psychology and Neuroscience.

The team behind the Amazone Study (back row, from left: Madelon Peters, Werner Mess, Anne Lukas, Maurice Theunissen and Dianne de Korte)