Chinese survivors of breast cancer have a better chance to recover if they write about their fears and emotions, a new study from the University of Houston suggests.

The study, published in the scholarly journal Health Psychology, showed that recovering patients who wrote for 20 to 30 minutes a day, three to four days a week for three consecutive weeks saw improvements in their immune function.

The "release offered by writing had a direct impact on the body's capacity to withstand stress and fight off infection and disease", the report said.

"Cancer patients, like war veterans in Iraq, can experience post-traumatic stress symptoms," said Qian Lu, assistant professor and director of the Culture and Health Research Center at the University of Houston.

Nineteen Chinese cancer survivors in the Los Angeles area participated in the study. They were within five years of their breast cancer diagnosis, and said they were comfortable speaking and writing in Chinese - either Mandarin or Cantonese.

All participants answered health assessment questionnaires before the study and were then given three sets of instructions.

In the first week, they were asked to write about their deepest thoughts on their experience with breast cancer. In the second, they were to write about their coping strategies - how they dealt with cancer-related stress. In the third, they were to write about their positive thoughts and feelings.

The aim of the writing exercise was "to facilitate emotional disclosure, effective coping and finding benefit, which would work together to bring stressors and personal goals into awareness and regulate thoughts and emotions relevant to the cancer experience", the report said.

Participants answered questionnaires three months, and again six months, after completing the writing assignments. Phone interviews were also conducted after the six-month follow-up.

Researchers assessed participants' quality of life, levels of fatigue, physical symptoms, thoughts and moods. The results suggested that expressive writing was associated with positive health outcomes, though the researchers acknowledged that one group of participants "did not allow for causal inferences".

Lu said she initially wanted to do the study because there were no similar studies done with many ethnic groups. The only one she had seen looked at non-Hispanic white women.

In addition, Chinese women had "a dramatic difference in attitudes" towards cancer than their white counterparts, thus the need to study the community more closely, Lu explained.

Unlike the Caucasian population, many Chinese have less knowledge of breast cancer and they feel that the cancer is very threatening, and they associate it with immediate death, she said.

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(China Daily 08/06/2014 page5)