Abstract Introduction Introduction: Coping with a breast cancer diagnosis is individualized and patient strategies vary throughout their dealing with this cancer. Coping methods include, but are not limited to: support groups, counseling, practicing mindfulness, spending time with family and friends, etc. One such technique is expressive writing (EW); writing that is focused on intrusive thoughts and emotional aspects related to their cancer. Objective Objectives: This meta-analysis reviewed published data regarding EW and its effects on the quality of life (QOL), including the sexual life, of breast cancer patients and survivors. Writing is a form of self-expression, which not only allows patients control of their emotions and treatment but also serves to improve the quality of care given to breast cancer patients and survivors. Thus, the ability to better implement personalized medicine remains at the center of holistic care. Additionally, we aimed to emphasize the existing clinical gap between minority groups, specifically Asian Americans, and ethnically prevalent groups. Methods Methods: A literature search was performed using PubMed to identify Randomized Controlled Trials (RCT) conducted within the United States between the years 2008 and 2023. Only RCTs with quantitative results from pre- and post-writing intervention were considered. While the structure of RCTs varied, all included interventions incorporated one or more EW group(s) and/or one or more NW (neutral writing) group(s). Measures of interest included: self-reflections from participants, linguistics, sleep quality, and Post-traumatic Stress (PTSD) symptoms. Results Results: The writing interventions studied included both NW and EW groups. These interventions resulted in various reductions of physical symptoms (ex: pain, nausea, headaches, etc.) and psychological changes (in mood, sleep, depression, and anxiety), after patients in EW groups self-reflected. Writing interventions with ethnic minorities are limited; however, writing interventions with Asian American participants improved PTSD-related symptoms and quality of life. Chinese-American women face cultural stigmatism, which may cause patients to fear sharing their deepest emotions, a possible explanation for the observed positive influence of EW for these participants. Unfortunately, no RCTs that associated EW with sexual well-being were analyzed. Conclusions Conclusions: The findings of this meta-analysis note that RCTs suggest that there is a link between EW and better coping with breast cancer. However, results may differ based on population, demographics, and cancer stage/treatment. The narrow scope of RCTs with ethnic minorities highlights that EW as a coping method for such populations remains understudied. As well, there are no data on its impact on sexual well-being-an area of research that requires more attention as women of all walks of life navigate their respective breast cancer diagnoses. Disclosure No.
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