Researchers studied 310 stomach cancer patients who had surgery to remove their tumors. Half received standard care, while the other half also got special help with talking through their feelings and improving their sleep for 12 weeks after surgery. The group that received the extra support felt less anxious and depressed, slept better, ate better, and had lower inflammation in their bodies. Most importantly, two years later, more people in the support group were still cancer-free and alive. This suggests that combining psychological support with sleep improvement during recovery from cancer surgery could help patients live longer and feel better.

The Quick Take

  • What they studied: Whether adding talk therapy and sleep improvement programs to standard cancer surgery care helps patients recover better and live longer
  • Who participated: 310 stomach cancer patients (stage I-III) who were having surgery to remove their tumors. They were split into two equal groups: one got regular care, the other got regular care plus 12 weeks of therapy and sleep help
  • Key finding: Patients who received therapy and sleep support had significantly better outcomes: they felt less anxious and depressed, slept better, gained weight and muscle back faster, had less body inflammation, and at 2 years, 46% more were still alive and cancer-free compared to the standard care group
  • What it means for you: If you or a loved one is having stomach cancer surgery, asking for psychological support and sleep help during recovery may improve both how you feel and your long-term survival chances. However, this was one study at one hospital, so talk with your doctor about whether this approach is right for your situation

The Research Details

This was a randomized controlled trial, which is considered one of the strongest types of medical research. Researchers took 310 patients scheduled for stomach cancer surgery and randomly assigned half to receive standard surgical care only, while the other half received standard care plus a special 12-week program. The program included six face-to-face sessions with a psychologist where patients talked through their feelings and experiences (called narrative therapy), plus a sleep improvement program based on proven cognitive behavioral techniques. Patients in the intervention group also had remote follow-up support after the in-person sessions ended.

The researchers measured many things at baseline (before surgery) and then at 1, 3, 6, 12, and 24 months after surgery. They looked at anxiety and depression levels, sleep quality, how well patients were eating and recovering nutritionally, markers of inflammation in the blood, quality of life, and whether patients remained cancer-free or alive at 2 years.

Because this was a randomized trial with a control group, researchers could be more confident that any differences between groups were due to the intervention itself, not just differences between the patients.

This research approach is important because it tests whether psychological and behavioral support during the critical recovery period after cancer surgery can actually change survival outcomes. Many cancer patients experience anxiety, depression, and sleep problems after surgery, which can slow healing and weaken the immune system. By testing a structured program that addresses these issues, researchers could determine if treating the whole person—mind and body—leads to better results than treating just the physical surgery recovery

This study has several strengths: it was a randomized controlled trial (the gold standard for testing treatments), included 310 patients (a reasonably large sample), followed patients for 2 years (long enough to see real survival differences), and measured multiple outcomes (not just one thing). The study was conducted at a single center, which means the results may not apply exactly the same way everywhere. The researchers used validated, well-established tools to measure anxiety, depression, sleep quality, and other outcomes, which increases reliability. However, we don’t know if patients knew which group they were in, which could have influenced their responses

What the Results Show

Patients who received the therapy and sleep program showed major improvements compared to the standard care group. Their anxiety and depression scores improved significantly more (p < 0.001, meaning this result is very unlikely to be due to chance). Their sleep quality improved much more dramatically as well. When researchers looked at nutritional recovery, patients in the intervention group gained back their body weight and muscle protein (albumin) faster and more completely.

Perhaps most importantly, patients in the intervention group had much lower levels of inflammatory markers in their blood—substances like CRP, IL-6, and TNF-alpha that indicate the body is inflamed. Chronic inflammation can interfere with healing and immune function, so reducing it is beneficial. Quality of life scores were consistently higher in the intervention group throughout the 2-year follow-up period.

At the 2-year mark, the survival differences became clear. Patients who received the intervention were significantly more likely to still be alive and cancer-free. Specifically, the intervention group had a 41% lower risk of cancer returning or dying (disease-free survival), and a 46% lower risk of dying from any cause (overall survival). These are substantial differences that suggest the intervention had real, meaningful effects on long-term outcomes.

Beyond the primary outcomes, the study found that patients in the intervention group maintained better emotional well-being throughout the 2-year period. They reported better quality of life consistently, not just at one time point. The improvements in sleep quality appeared early (within the first month) and were sustained throughout follow-up. The nutritional improvements (weight and protein levels) also appeared early and were maintained, suggesting that better sleep and less anxiety helped patients eat better and recover their strength. The reduction in inflammatory markers was consistent across multiple measures, suggesting a genuine reduction in body-wide inflammation rather than a chance finding

Previous research has shown that anxiety, depression, and poor sleep are common after cancer surgery and can slow recovery. Some studies suggested these psychological factors might affect survival, but few had tested whether treating them could actually improve survival outcomes. This study is among the first to show that a structured intervention addressing both psychological and sleep issues during the critical perioperative period (around the time of surgery) can lead to measurable survival benefits. The findings align with growing evidence that the mind and body are connected in cancer recovery, and that treating psychological distress isn’t just about feeling better—it may actually help the body fight cancer more effectively

This study was conducted at a single hospital in one location, so the results might not apply exactly the same way in other hospitals or countries with different healthcare systems. The study doesn’t tell us which part of the intervention was most important—the talk therapy, the sleep program, or the combination. Patients and their doctors may have known which group they were in, which could have influenced how they reported their symptoms or how hard they tried to follow recommendations. The study included only stomach cancer patients, so we don’t know if the same benefits would occur with other cancer types. Finally, while 310 patients is a good sample size, it’s still relatively small for a survival study, so the results should be confirmed in larger studies before becoming standard practice everywhere

The Bottom Line

If you are scheduled for stomach cancer surgery, discuss with your surgical team whether adding psychological support and sleep improvement programs to your care plan might be beneficial. The evidence from this study suggests these interventions are safe, low-cost, and may improve both how you feel during recovery and your long-term survival. However, this is based on one study, so ask your doctors whether similar programs are available at your hospital and whether they recommend them for your specific situation. High confidence: psychological support and sleep help improve quality of life and reduce anxiety/depression. Moderate confidence: these interventions may improve long-term survival (based on this one study)

This research is most relevant to people with stage I-III stomach cancer who are planning to have surgery. It may also be relevant to people recovering from other types of cancer surgery, though the evidence is strongest for stomach cancer. Family members and caregivers should also pay attention, as they can help support the patient’s participation in therapy and sleep improvement efforts. Healthcare providers, especially surgical oncologists and cancer centers, should consider whether they can implement similar programs. People with other types of cancer should not assume these results apply to them without discussing it with their doctors, though the general principles of addressing psychological health and sleep during cancer recovery are likely beneficial across cancer types

Improvements in anxiety, depression, and sleep quality appeared within the first month after starting the intervention. Nutritional recovery improvements also appeared early. However, the survival benefits only became clearly visible at 2 years, suggesting that the benefits of these interventions accumulate over time. You shouldn’t expect to see major survival differences in the first few months—the real value appears to be in sustained, long-term benefits. Most patients should expect to feel better emotionally and sleep better within weeks, but the full benefits for long-term survival may take months or years to fully realize

Want to Apply This Research?

  • Track sleep quality (hours slept, how rested you feel on a 1-10 scale), anxiety/mood levels (using a simple daily mood rating), and appetite/nutrition (meals eaten, weight weekly). Record these daily or weekly in your app to see patterns and share with your healthcare team
  • Use the app to schedule and remind yourself of therapy sessions and sleep improvement activities. Set daily sleep goals (consistent bedtime, 7-9 hours), practice relaxation techniques before bed, and use the app to journal about your feelings and recovery progress. Share your mood and sleep data with your therapist or doctor to track improvements
  • Create a long-term dashboard showing trends in sleep quality, mood, weight/nutrition, and overall quality of life over months. Set monthly check-in reminders to review progress and adjust goals. If you notice worsening anxiety, depression, or sleep quality, alert your healthcare team immediately. Track any cancer-related symptoms or concerns and discuss patterns with your doctor at regular follow-up appointments

This research describes findings from one clinical trial and should not replace personalized medical advice from your healthcare team. While the study suggests that psychological support and sleep improvement may help stomach cancer patients recover better and potentially live longer, individual results vary. Before starting any new therapy or making changes to your cancer care plan, discuss these findings with your oncologist or surgical team. This information is for educational purposes and is not a substitute for professional medical diagnosis, treatment, or advice. If you are experiencing anxiety, depression, or sleep problems after cancer surgery, please speak with your healthcare provider about appropriate support options available to you.