Skip to main content

Advertisement

SpringerLink
Log in

Art Therapy in Advanced Cancer. A Mapping Review of the Evidence

  • Integrative Care (M Frenkel, Section Editor)
  • Published:
Current Oncology Reports Aims and scope Submit manuscript

A Correction to this article was published on 21 September 2022

This article has been updated

Abstract

Purpose of Review

The benefits of arts in improving well-being in end-of-life patients have been stated by the WHO. To inspire clinical practice and future research, we performed a mapping review of the current evidence on the effectiveness of art therapy interventions in stage III and IV cancer patients and their relatives.

Recent Findings

We identified 14 studies. Benefits reported by the authors were grouped as improved emotional and spiritual condition, symptom relief, perception of well-being, satisfaction, and helpfulness. As a body of evidence, notable limitations were observed: Only 1 study was a randomized controlled trial (RCT), and there was heterogeneity in the interventions and outcome measures.

Summary

This mapping review highlights the evidence available on the effectiveness of art therapy in advanced cancer, which remains limited and presents specific challenges. It also provides a visual representation of the reported benefits, encouraging further and more rigorous investigation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Change history

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. WHO Expert Committee on Cancer Pain Relief and Active Supportive Care & World Health Organization. Cancer pain relief and palliative care : report of a WHO expert committee [‎meeting held in Geneva from 3 to 10 July 1989]‎. World Health Organization; 1990. https://apps.who.int/iris/handle/10665/39524.

  2. •• Fancourt D, Finn S. What is the evidence on the role of the arts in improving health and well-being? A scoping review. Copenhagen: WHO Regional Office for Europe; 2019 (Health Evidence Network (HEN) synthesis report 67). From an authoritative source in health, this review acknowledges the global evidence (results from over 3000 studies in diverse disciplines) on the contribution of the arts to the prevention, management, and treatment of illness across the lifespan.

  3. •• Wood MJ, Jacobson B, Cridford H. The international handbook of art therapy in palliative and bereavement care. New York and London: Routledge; 2019. This handbook presents multicultural and international perspectives on how art therapy can help to alleviate the distress and suffering of individuals, groups, families, communities, and nations facing death and dying as well as grief and loss.

    Book  Google Scholar 

  4. AATA. About art therapy. The American Art Therapy Association website: https://www.arttherapy.org/upload/2017_DefinitionofProfession.pdf. Accessed May 16, 2021.

  5. BAAT. About art therapy. The British Association of Art Therapists website: https://www.baat.org/About-Art-Therapy. Accessed May 16, 2021.

  6. BradtJ GS. Creative arts therapies defined. JAMA Intern Med. 2013;173:969–70. https://doi.org/10.1001/jamainternmed.2013.6145.

    Article  Google Scholar 

  7. Wood MJM, Molassiotis A, Payne S. What research evidence is there for the use of art therapy in the management of symptoms in adults with cancer. A systematic review. Psychooncology. 2011;20(2):135–45. https://doi.org/10.1002/pon.1722.

    Article  PubMed  Google Scholar 

  8. Puetz TW, Morley CA, Herring MP. Effects of creative arts therapies on psycological symptoms and quality of life in patients with cancer. JAMA Intern Med. 2013;173(11):960–9. https://doi.org/10.1001/jamainternmed.2013.836.

    Article  PubMed  Google Scholar 

  9. Boehm K, Cramer H, Staroszynski T, Ostermann T. Arts therapies for anxiety, depression and quality of life in breast cancer patients: a systematic review and meta-analysis. J Evid Based Complementary Altern Med. 2015;20(2):87–93. https://doi.org/10.1177/2156587214555714.

    Article  Google Scholar 

  10. Archer S, Buxton S, Sheffield D. The effect of creative psychological interventions on psychological outcomes for adult cancer patients: a systematic review of randomised controlled trials. Psychooncology. 2015;24(1):1–10. https://doi.org/10.1002/pon.3607.

    Article  CAS  PubMed  Google Scholar 

  11. Kim KS, Loring S, Kwekkeboom K. Use of art-making intervention for pain and quality of life among cancer patients. J Holist Nurs. 2018;36(4):341–53. https://doi.org/10.1177/0898010117726633.

    Article  PubMed  Google Scholar 

  12. Tang Y, Fu F, Gao H, Shen L, Chi I, Bai Z. Art therapy for anxiety, depression, and fatigue in females with breast cancer: a systematic review. J Psychosoc Oncol. 2019;37(1):79–95. https://doi.org/10.1080/07347332.2018.1506855.

    Article  PubMed  Google Scholar 

  13. Fu W, Huang Y, Lin X, Ren J, Zhang M. The effect of art therapy in women with gynecological cancer: a systematic review. Evidence-Based Complementary and Alternative Medicine. 2020;2020, Article ID8063172. https://doi.org/10.1155/2020/8063172.

  14. Cheng P, Xu L, Zhang J, Liu W, Zhu J. Role of arts therapy in patients with breast and gynecological cancers: a systematic review and meta-analysis. J Palliat Med. 2021;24(3):443–52. https://doi.org/10.1089/jpm.2020.0468.

    Article  PubMed  Google Scholar 

  15. Kennett CE. Participation in a creative arts project can foster hope in a hospice day centre. Palliat Med. 2000;14:419–25. https://doi.org/10.1191/026921600701536255.

    Article  CAS  PubMed  Google Scholar 

  16. Lin MH, Sl M, Kuo YC, Py Wu, Lin CL, Tsai MH, Chen TJ, Hwang SJ. Art therapy for terminal cancer patients in a hospice palliative care unit in Taiwan. Palliat Support Care. 2012;10:51–7. https://doi.org/10.1017/S1478951511000587.

    Article  PubMed  Google Scholar 

  17. Rhondali W, Chirac A, Filbet M. L’art-thérapie en soins palliatifs: une étude qualitative. Médecine palliative. 2013;12:279–85. https://doi.org/10.1016/j.medpal.2012.11.002.

    Article  Google Scholar 

  18. Lefèvre C, Ledoux M, Filbet M. Art therapy among palliative cancer patients: aesthetic dimensions and impacts on symptoms. Palliat Support Care. 2016;14(4):376–80. https://doi.org/10.1017/S1478951515001017.

    Article  PubMed  Google Scholar 

  19. Schaefer MR, Spencer SK, Barnett M, Reynolds NC, Madan-Swain A. Legacy artwork in pediatric oncology: the impact on bereaved caregivers’ psychological functioning and grief. J Palliat Med. 2019;22(9):1124–8. https://doi.org/10.1089/jpm.2018.0329.

    Article  PubMed  Google Scholar 

  20. Lefèvre C, Economos G, Tricou C, Perceau-Chambard E, Filbet M. Art therapy and social function in palliative care patients: a mixed-method pilot study. BMJ Support Palliat Care. 2022;12(e1):e75–82. https://doi.org/10.1136/bmjspcare-2019-001974.

  21. Park S, Song H. The art therapy experiences of patients and their family members in Hospice Palliative Care. Korean J Hosp Palliat Care. 2020;23(4):183–97. https://doi.org/10.14475/kjhpc.2020.23.4.183.

    Article  Google Scholar 

  22. Schaefer MR, Wagoner ST, Young ME, Madan-Swain A, Barnett M, Gray WN. Healing the hearts of bereaved parents: impact of legacy artwork on grief in pediatric oncology. J Pain Symptom Manage. 2020;60(4):790–800. https://doi.org/10.1016/j.jpainsymman.2020.04.018.

    Article  PubMed  Google Scholar 

  23. Collette N, Güell E, Fariñas O, Pascual A. Art therapy in a palliative care unit: symptom relief and perceived helpfulness in patients and their relatives. J Pain Symptom Manage. 2021;61(1):103–11. https://doi.org/10.1016/j.jpainsymman.2020.07.027.

    Article  PubMed  Google Scholar 

  24. Visser A, Op’T Hoog M. Education of creative art therapy to cancer patients: evaluation and effects. J Cancer Educ. 2008;23:80–4. https://doi.org/10.1080/08858190701821204.

    Article  PubMed  Google Scholar 

  25. Bozcuk H, Ozcan K, Erdogan C, Mutlu H, Demir M, Coskun S. A comparative study of art therapy in cancer patients receiving chemotherapy and improvement in quality of life by watercolor painting. Complement Ther Med. 2017;30:67–72. https://doi.org/10.1016/j.ctim.2016.11.006.

    Article  CAS  PubMed  Google Scholar 

  26. Lee J, Choi MY, Kim YB, Sun J, Park EJ, Kim JH, Kang M, Koom WS. Art therapy based on appreciation of famous paintings and its effect on distress among cancer patients. Qual Life Res. 2017;26:707–15. https://doi.org/10.1007/s11136-016-1473-5.

    Article  PubMed  Google Scholar 

  27. Meghani SH, Peterson C, Kaiser DH, Rhodes J, Rao H, Chittams J, Chatterjee A. A pilot study of a mindfulness-based art therapy intervention in outpatients with cancer. Am J Hosp Palliat Care. 2018;35(9):1195–200. https://doi.org/10.1177/1049909118760304.

    Article  PubMed  Google Scholar 

  28. Radl D, Vita M, Gerber N, Gracely EJ, Bradt J. The effects of Self-Book© art therapy on cancer-related distress in female cancer patients during active treatment: a randomized controlled trial. Psychooncology. 2018;27(9):2087–95. https://doi.org/10.1002/pon.4758.

    Article  PubMed  Google Scholar 

  29. Boutron I, Altman DG, Moher D, Schulz KF, Ravaud P for the CONSORT NPT Group. CONSORT statement for randomized trials of nonpharmacologic treatments: a 2017 update and a CONSORT extension for nonpharmacologic trial abstracts. Ann Intern Med. 2017;167(1):40–7. https://doi.org/10.7326/M17-0046.

    Article  PubMed  Google Scholar 

  30. Higginson I, Evans CJ, Grande G, Preston N, Morgan M, McCrone P, Lewis P, Fayers P, Handing R, Hotopf M, Murray SA, Benalia H, Gysels M, Farquhar M, Todd C and on behalf of MORECare. Evaluating complex interventions in End-of-Life Care: the MORECare statement on good practice generated by a synthesis of transparent expert consultations and systematic reviews. BMC Med. 2013;11:111. https://doi.org/10.1186/1741-7015-11-111.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Solomon S, Lawlor K. Death anxiety: the challenge and the promise of whole person care. In: Hutchinson TA, editor. Whole person care. Montreal: Springer; 2011. p. 97–107.

    Chapter  Google Scholar 

  32. Ganzel BL. Trauma-informed hospice and palliative care. Gerontologist. 2018;58(3):409–19. https://doi.org/10.1093/geront/gnw146.

    Article  PubMed  Google Scholar 

  33. Mount BM, Boston PH, Cohen SR. Healing connections: on moving from suffering to a sense of well-being. J Pain Symptom Manage. 2007;33(4):372–88. https://doi.org/10.1016/j.jpainsymman.2006.09.014.

    Article  PubMed  Google Scholar 

  34. Jacobs JM, Shaffer KM, Nipp RD, Fishbein JN, MacDonald J, El-Jawahri A, et al. Distress is interdependent in patients and caregivers with newly diagnosed incurable cancers. Ann Behav Med. 2017;51(4):519–31. https://doi.org/10.1007/s12160-017-9875-3.

    Article  PubMed  Google Scholar 

  35. Winnicott DW. Playing and reality. London: Tavistock Publications; 1971.

    Google Scholar 

  36. Stroebe MS, Schut H. The dual process model of coping with bereavement: rationale and description. Death Stud. 1999;23(3):197–224. https://doi.org/10.1080/074811899201046.

    Article  CAS  PubMed  Google Scholar 

  37. Neimeyer RA. Meaning reconstruction & the experience of loss. Washington DC: American Psychological Association; 2001.

    Book  Google Scholar 

  38. Arthur J, Sriram Yennurajalingam S, Nguyen L, Tanco K, Chisholm G, Hui D, Bruera E. The routine use of the Edmonton classification system for cancer pain in an outpatient supportive care center. Palliat Support Care. 2015;13(5):1185–92. https://doi.org/10.1017/S1478951514001205.

    Article  PubMed  Google Scholar 

  39. Nainis NA. Approaches to art therapy for cancer inpatients: research and practice considerations. Art Ther. 2008;25(3):115–21. https://doi.org/10.1080/07421656.2008.10129597.

    Article  Google Scholar 

  40. Rhondali W, Lasserre E, Filbet M. Art therapy among palliative care inpatients with advanced cancer. Palliat Med. 2012;27(6):571–2. https://doi.org/10.1177/0269216312471413.

    Article  Google Scholar 

  41. Wood M. Art therapy in palliative care. In: Pratt M, Wood M, editors. Art Therapy in Palliative Care: The Creative Response (1st ed.). London and New York: Routledge; 1998. pp. 226–37. https://doi.org/10.4324/9781315788012.

  42. Mount BM. Existential suffering and the determinants of healing. Eur J Palliat Care 2003, 10 (2) Supplement: 40–2.

  43. Kearney M, Weininger R. Care of the soul. In: Cobb MR, Puchalski CM, Rumbold B, editors. Oxford textbook of spirituality in healthcare. New York: Oxford University Press; 2012. p. 273–8. https://doi.org/10.1093/med/9780199571390.003.0038.

    Chapter  Google Scholar 

  44. Ray A, Block SD, Friedlander RJ, Zhang B, Maciejewski PK, Prigerson HG. Peaceful awareness in patients with advanced cancer. J Palliat Med. 2006;9(6):1359–68. https://doi.org/10.1089/jpm.2006.9.1359.

    Article  PubMed  Google Scholar 

  45. • Brenner KO, Rosenberg LB, Cramer MA, Jacobsen JC, Applebaum AJ, Block SD, et al. Exploring the psychological aspects of palliative care: lessons learned from an interdisciplinary seminar of experts. J Palliat Med. 2021;24(9):1274–9. https://doi.org/10.1089/jpm.2021.0224. As a conceptual framework, this special interdisciplinary report describes the key psychological aspects that underlie optimal adaptive coping in palliative care patients, a central theme being the dialectic of living well while acknowledging dying.

    Article  PubMed  Google Scholar 

  46. Austin P, Mac LR. Finding peace in clinical settings: a narrative review of concept and practice. Palliat Support Care. 2017;15(4):490–8. https://doi.org/10.1017/S1478951516000924.

    Article  PubMed  Google Scholar 

  47. Arnold BL, Lloyd LS. Harnessing complex emergent metaphors for effective communication in palliative care: a multimodel perceptual analysis of hospice patients’reports of transcendence experiences. Am J Hosp Palliat Care. 2014;31(3):292–9. https://doi.org/10.1177/1049909113490821.

    Article  PubMed  Google Scholar 

  48. Collette N. Arteterapia en el final de la vida. (PhD dissertation) Departamento de Personalidad, Evaluación y Tratamientos psicológicos, Facultad de Psicología, Universitat de València, 2013. Available from https://www.educacion.gob.es/teseo/mostrarRef.do?ref=1042479

  49. Collette N. Deepening the inner world. When art therapy meets spiritual needs. In: Wood MJ, Jacobson B, Cridford H, editors. The international handbook of art therapy in palliative and bereavement care (1st ed.) New York and London: Routledge; 2019. p. 3–16. https://doi.org/10.4324/9781315110530.

  50. •• Srolovitz M, Borgwardt J, Burkart M, Clements-Cortes A, Czamanski-Cohen J, Ortiz Guzman M, Hicks MG, Kaimal G, Lederman L, Potash JS, Yazdian Rubin S, Stafford D, Wibben A, Wood M, Youngwerth J, Jones CA, Kwok IB. Top ten tips palliative care clinicians should know about music and art therapy. J Palliat Med. 2022;25(1):135–44. https://doi.org/10.1089/jpm.2021.0481. Art therapists, as increasingly available specialists for the palliative care teams, are advancing diverse and unique clinical services to effectively meet the holistic needs of patients with serious illnesses and their families.

    Article  PubMed  Google Scholar 

  51. Alvarez Bustins G. Retos metodológicos en la evaluación de la eficacia de la terapia manual [Methodological challenges in the evaluation of the effectiveness of manual therapy] (PhD dissertation). Departamento de Pediatría, de Obstetricia y Ginecología,y de Medicina Preventiva y Salud Pública. Facultad de Medicina, Universitat Autònoma de Barcelona. 2021.

  52. Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ. 2014;348: g1687. https://doi.org/10.1136/bmj.g1687.

    Article  PubMed  Google Scholar 

  53. Howick J, Webster RK, Rees JL, Turner R, Macdonald H, Price A, et al. TIDieR-Placebo: a guide and checklist for reporting placebo and sham controls. PLoS Med. 2020;17(9):1–15. https://doi.org/10.1371/journal.pmed.1003294.

    Article  Google Scholar 

  54. Kapitan L. Introduction to art therapy research. New York and London: Routledge; 2018.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain

    Nadia Collette, Ivan Sola & Xavier Bonfill

  2. Unidad de Cuidados Paliativos, Hospital de la Santa Creu i Sant Pau, Carrer Sant Quintí, 89, 08026, Barcelona, Spain

    Nadia Collette & Antonio Pascual

  3. CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain

    Ivan Sola & Xavier Bonfill

  4. Universitat Autònoma de Barcelona, Barcelona, Spain

    Ivan Sola, Xavier Bonfill & Antonio Pascual

Authors
  1. Nadia Collette
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ivan Sola
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Xavier Bonfill
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Antonio Pascual
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Antonio Pascual.

Ethics declarations

Conflict of Interest

NC was hired by the Hospital Sant Pau Research Institute through a grant from Fundación Mémora, which was not involved in the conduct of this review or the preparation of this article. The other co-authors declare no competing interests.

Human and Animal Rights and Informed Consent

NC and AP are co-authors of one study with human subjects that has been included in this review. It was approved by the Clinical Research Ethics Committee of the hospital, and all participants had provided written informed consent.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Integrative Care

The original online version of this article was revised: The Figure 2 image is incorrect.

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Collette, N., Sola, I., Bonfill, X. et al. Art Therapy in Advanced Cancer. A Mapping Review of the Evidence. Curr Oncol Rep 24, 1715–1730 (2022). https://doi.org/10.1007/s11912-022-01321-0

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11912-022-01321-0

Keywords

Search

Navigation