Stress management after breast cancer (SEB)

In the research project Stress Management after Breast Cancer (SEB), we are testing a digital health tool for coping with stress for women who have had breast cancer or precancerous lesions.

Last updated: 8/8/2023

Background

Breast cancer is the most common cancer among women. In Norway, 3726 women were diagnosed with breast cancer in 2019. In the face of a serious diagnosis such as cancer, many may experience increased feelings of stress.

We know that different stress management strategies can prevent problems related to worry, uncertainty and painful thoughts and feelings.

We still have too little information about which strategy works best for each individual. In this project, we are therefore testing the use of two different stress management programmes via the app StressProffen.

Both programmes have been developed by experts in the relevant disciplines, and are based on research-based methods that have proven to be effective when used in, for example, group therapy.

Purpose

This research project has two overarching objectives:

To compare the level of health-related quality of life in Norwegian breast cancer patients with the rest of the population.
To test the effect of two digital interventions on health-related quality of life in breast cancer patients, with the possibility of large-scale implementation.

The objectives are addressed through a case-control study, as well as follow-up of the participants over time, and a three-arm randomised controlled intervention study.

Health-related quality of life over time

The purpose of the case-control study is to compare the level of health-related quality of life in Norwegian breast cancer patients with the general population. In addition, we will follow the participants over time.

Cases are patients diagnosed with breast cancer or precancerous lesions in the period 2020–2022. The controls are collected from the rest of the population and are age- and region-matched with cases.

For cases, we will collect the questionnaire at baseline, as well as after one and three years from the time of diagnosis. For controls, the collection of questionnaires will follow the same timeline as for cases.

This gives us the opportunity to compare health-related quality of life in these women over time. In this sub-study, we collect data via the population survey on health and quality of life under the auspices of the Cancer Registry.

Randomised controlled intervention study

The participants in the randomised controlled intervention study are women in the age group 20–69 years who have been diagnosed with breast cancer or precancerous lesions in the period 2020–2022.

Inclusion in the study also depends on tumour characteristics, including receptor status, as well as participation in the population survey on health and quality of life at baseline. Participants for this sub-study are drawn from the study on health-related quality of life.

In the randomized controlled intervention study, participants are randomly divided into three groups. Participants in two of the groups get access to an app with somewhat different content. Participants in the third group, the control group, will be offered use of the app after their participation in the study has ended.

The purpose of this sub-study is to compare the two groups of participants who receive the intervention with the participants in the control group.

Participants in the randomised controlled intervention study will be asked to complete a questionnaire on quality of life at baseline, as well as after one, two and three years from diagnosis.

Organization

This is a research project under the auspices of the Cancer Registry of Norway in close collaboration with Oslo University Hospital, the Norwegian School of Sport Sciences and Western Norway University of Applied Sciences.

The Cancer Registry of Norway receives information on cancer cases from the treating hospital and administers the day-to-day operation of the study.

Oslo University Hospital, represented by the Department of Digital Health Research, has developed and operates the app-based program StressProffen. In this research project, we have further developed the existing program with the help of experts from Western Norway University of Applied Sciences and the Norwegian School of Sport Sciences.

If you have questions about this research project, please contact postdoc Karianne Svendsen kasv@kreftregisteret.no.

Team

Giske Ursin, Ine Marie Larsson, Ylva Gjelsvik, Tanja Nygård, Ingunn Aune, Tor Åge Myklebust, Jan Nygård, Kjersti Østby and Emil Lahlum at the Cancer Registry of Norway.
Elin Børøsund, Lise Solberg Nes, Christine Rygg, Kristin V. Reinertsen, Bjørn Naume, Cecilie E. Kiserud and Ellen Schlichting at Oslo University Hospital.
Anders Meland at the Norwegian School of Sport Sciences.
Hege Randi Eriksen at Western Norway University.
Helle Skjerven at Vestre Viken and the National Quality Registry for Breast Cancer.
Ingvil Mjaaland at Stavanger University Hospital.
Barbara Wasson at the University of Bergen.
Torkil Berge at Diakonhjemmet Hospital.
Trudie Chalder at Kings College, London, UK.
Linda E. Carlson at the University of Calgary, Alberta, Canada.
Michael H. Antoni at the University of Miami, Florida, USA.
Birthe Helene Moen at the Norwegian Breast Cancer Society.

Publication of results

The study protocol has been peer-reviewed and is published here: https://doi.org/10.2196/47195

Status as of October 2023

The first invitations to the population survey on health and quality of life were sent out in September 2020. Invitations to participate in the population survey were then extended to women who have been diagnosed with breast cancer or precancerous lesions in 2020. The final participant was enrolled in May 2023. All participants are followed-up with annual, digital surveys.