It's certainly not the final word on the subject, but researchers say that writing can help cancer patients better deal with the trauma and challenges of their disease.

Research done by Susan Bauer-Wu, director of the Cantor Center for Nursing and Patient Care Research at the Dana Farber Cancer Institute, Boston, suggests that by spending 30 minutes each day writing out their innermost thoughts and feelings, cancer patients can significantly boost their mental and physical health.

"Many people are so surprised at how it really works," says Bauer-Wu. "They'll go through the process and have that 'A-ha' moment. They'll tell us, 'Wow, I never realized this about myself, or about this just came out onto the paper."

The Theory

The concept is called "expressive writing therapy." Patients are encouraged to write what is on their mind, letting their hopes and fears flow out in a natural, unrestrained way. It's akin to keeping a journal, but more focused on the things that might be bothering you or triggering stress.

"Don't worry about the punctuation, the words, just go with the process," Bauer-Wu says. "We also encourage them to build on whatever they have written before."

For many patients, such written expression provides a catharsis-a release and articulation of issues bottled up inside and a healthy coming to terms with issues related to living with cancer.

"It's about stepping back and thinking about things in a different way, making linkages," explains Robin Fivush, a professor of psychology at Emory University who has conducted her own research on expressive writing.

"It's not just about expressing the emotion, because then you'd just ruminate on it," says Fivush. "If you take a close look at those who benefit from it most, you see a lot of them using what we call 'cognitive processing' words—'I realize, I understand, now I see that."

Insights like these appear to help patients with cancer or other illnesses cope better, studies suggest. In one review of 140 studies on this subject, the practice of expressive writing seems very effective," she adds.

The Findings

Bauer-Wu has conducted three studies, tracking the effects of expressive writing and journal therapy on patients with breast and other cancers. "In my work, we do a four-day intervention, but then repeat it a month later and then a month later again." She adds that some patients benefit from longer-duration writing therapy.

"One of the things that's been found in cancer patients across different studies is what we call 'improvements in health-care utilization," she says. "Patients end up going to their doctor or calling nurses less frequently. They need fewer sessions with a mental health counselor. Basically, they are having fewer physical symptoms and coping better."

"There's data that suggest that writing out your emotions eases stress and, in turn, boosts the immune system," adds Fivush.

Patients can write using a pen and paper or computer. "What's most important is that you find that place each day where you can most freely write," Bauer-Wu says.

But this therapy works better for some cancer patients than others. Preadolescent children, especially, will probably not benefit, says Fivush. "We think that they may not have the cognitive or emotional skills [at that age] to work through things on their own."

Bauer-Wu says it's self-care. "People can heal themselves." According to Bauer-Wu, patients who are solitary and private by nature may benefit the most. "There's a lot of hype about support groups, but we know that some people just aren't talkers," she says. "To me, expressive writing is a wonderful alternative for these people. It gives them a way to express their feelings and process what's going on in their minds."

One key is to not write with an intended audience in mind. In most cases, the researcher says, patients don't even have to read back their own journal entries to benefit. "It's the act of writing that seems to be important," Fivush says.

Massage Relieves Cancer Symptoms

It can reduce pain, nausea, fatigue and depression as effectively as drug therapy but without side effects. Insurance coverage varies. Look for a certified massage therapist who has training with cancer patients.

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