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P02.21. Short- and long-term effects of expressive writing in patients with renal cell carcinoma


Most previous research examining the efficacy of brief expressive writing interventions have used small sample sizes and followed people for no more than 3 months. We conducted a large randomized trial to examine an emotion-based writing intervention for patients with renal cell carcinoma and followed them for 10 months after the end of the writing sessions.


Two hundred patients with renal cell carcinoma were randomly assigned to either an expressive writing group (EW) or a neutral writing group (NW) and asked to write on four separate occasions over 10 days for a maximum of 20 minutes at each writing session. Patients completed the MD Anderson Symptom Inventory (MDASI), Brief Fatigue Inventory, SF-36, IES, CES-D, and PSQI at baseline and then again 1 and 10 months after the writing sessions.


The mean age of the participants was 58 (range 34-82 years), 41% were women, and 46% had advanced disease. Examination of group differences 1 month after the writing sessions, controlling for the respective baseline measure, revealed lower IES scores for the EW group (intrusive thoughts: EW, 5.0 v NW, 7.2; p<.02; avoidance behaviors: EW, 6.3 v NW, 8.7; p<.07). At the 10 month time point, the EW group reported lower MDASI interference scores (symptoms interfering with QOL) (EW: 6.4 v NW: 9.9; p<.04), higher levels of SF-36 Role Physical scores (EW: 69.6 v NW: 54.0; p<.02), and fewer sleep disturbances (subscale of the PSQI; EW: 1.4 v NW: 1.6; p<.05). Means for the other SF-36 subscales at 10 months were in the expected direction, but did not reach statistical significance. There were no group differences for CES-D or fatigue scores at any time point.


These findings indicate expressive writing leads to short-term reduction in intrusive thoughts about the cancer experience and results in long-term improvement in aspects of quality of life.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Cohen, L., Tannir, N., Jonasch, E. et al. P02.21. Short- and long-term effects of expressive writing in patients with renal cell carcinoma. BMC Complement Altern Med 12 (Suppl 1), P77 (2012).

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