by EBSCO Medical Review Board

Breast cancer is the most common cancer in women. Women who have breast cancer may undergo a variety of treatments, including surgery, radiation therapy, chemotherapy, and other medications, depending on the stage and type of cancer. These treatments, along with the disease itself, can cause physical and emotional distress. Treatment side effects may include nausea, anemia, pain, or bone loss. Some women add alternative medicine to their treatment plans to help manage breast cancer.

Expressive writing is thought to improve health outcomes because it supports the concept that emotional expression is an important part of good health. Researchers wanted to determine the effects on quality of life, negative emotions, and disease-related symptoms among women with breast cancer. The study, published in Complementary Therapies in Medicine, found that non-pharmacologic interventions, including expressive writing, may have an effect on a middle-age woman with breast cancer.

About the Study

The systematic review included 23 randomized controlled trials comparing acupoint stimulation, massage therapy, and expressive writing to no treatment and/or placebo in 2,346 women with breast cancer. In the 7 studies that evaluated expressive writing, participants were asked to write about their deepest thoughts on their cancer experience and impending surgery over 3-4 sessions of 20 minutes each. The total treatment duration ranged from 4 days to 7 weeks.

Compared to the participants in the control group of neutral writing or no writing, the review found that expressive writing was associated with a small improvement in quality of life using an assessment scale in 2 trials with 136 participants. There was no significant difference in anxiety, depression, fatigue, or sleep.

How Does This Affect You?

A systematic review combines a number of smaller trials to create a larger pool of participants. The larger the pool of participants the more reliable the outcomes are. However, the review is only as reliable as the studies that are included. The 7 expressive writing studies used differing interventions and controls, making it more difficult to pool and compare data. Furthermore, the results of the studies may not be clinically meaningful when compared to the control.

Multiple studies have associated expressive writing with improved quality of life in those who are combating illnesses, such as asthma and arthritis. Expressive writing is easy and safe to do at home. If you have breast cancer and want to learn about alternative methods to manage your condition, talk to your doctor.


American Cancer Society  

Cancer Care  


Breast cancer in women. EBSCO DynaMed Plus website. Available at: . Updated May 15, 2017. Accessed June 14, 2017.

Lee PL, Tam KW, et al. Acupoint stimulation, massage therapy and expressive writing for breast cancer: a systematic review and meta-analysis of randomized controlled trials. Complement Ther Med. 2016 Aug;27:87-101.

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