Overview

• Art therapy is recognised in the UK and other countries as part of the support that may be offered to people who are undergoing or have recently completed cancer treatment. In the UK, some people can access it through the NHS via their treatment team.
• Studies on art therapy with people affected by cancer have been carried out in many countries, including Canada, China, France, Germany, Hong Kong, Iran, Israel, Italy, Japan, Korea, the Netherlands, Spain, Sweden, Taiwan, Turkey, the UK and the USA.
• In these studies, art therapy was offered either during or after cancer treatment, either in a group or one-to-one, and the number of sessions varied from one-off to 22 sessions. In some studies [3-8], as well as art therapy, the sessions included practising mindfulness, which means focusing on the present moment [9].
• The research studies, including randomised controlled trials, reported positive outcomes for stress [10], relationships [10], distress, [4, 5, 7, 11], quality of life [4, 5, 7, 12], mood [5, 11, 13], anxiety [5, 8, 13], fatigue [14], spiritual wellbeing [15] and self-acceptance [13, 16].

What outcomes have people experienced following art therapy? 

Reports from randomised controlled trials suggest that people can experience the following benefits from attending art therapy during or after cancer treatment:

• coping better with stress [10]
• improved relationships [10]
• reduced distress [4, 5, 7, 11]
• improved quality of life [4, 5, 7, 12]
• improved mood [5, 11, 13]
• reduced anxiety or stress [5, 8, 13]
• less fatigue [14]
• increased spiritual wellbeing [15]
• improved emotional awareness and self-acceptance [13, 16]

Why art therapy may be helpful

A study with women with breast and/or gynaecological cancer included testimonies from service users [17]:

Expressing emotions and gaining new perspectives

In qualitative studies involving interviews or written feedback from participants, people reported that artmaking in a supportive environment helped them to communicate their distress or pain in a manageable way. Some people came to see new perspectives on their life or felt able to express new aspects of themselves. Participants also appreciated the support of the art therapist, and other group members in group art therapy [19 – 28].

One study was a survey of 32 art therapists and 55 recipients of cancer treatment across the UK [28]. Most service users reported that art therapy was easy to engage with, enjoyable and calming. They also said it helped them gain new perspectives on themselves and express difficult feelings without necessarily having to use words.

One person from the study describes the importance of art therapy to them:

In this video from the United States, people with a cancer diagnosis describe their experiences of art therapy:

In this Ted talk, Anise Bullimore shares her experience of art therapy with the Macmillan Cancer Support team.

 

About the research studies

Randomised controlled trials

So far, there have been 14 randomised controlled trials (RCTs) on art therapy with people affected by cancer. Participants of these trials were randomly assigned to receive art therapy or not, and their psychological wellbeing outcomes were compared. Most participants were women with breast cancer. [4, 5, 7, 10-16]

An advantage of RCTs is that we should be able to assume that it was the art therapy that led to participants’ improved wellbeing and not something else. However, these trials are not perfect: for example, some participants drop out of them, or the therapy may not be delivered in a consistent way, or not all the right measures are made and all at the right times. Therefore, it is always worth being cautious in interpreting trial results.

Before and after studies

There have also been 16 research studies that compared people’s responses to questionnaires before and after art therapy but did not compare them with people who had no art therapy [3, 6, 17, 29-40]. These studies included people in treatment for a greater range of types of cancers than the controlled trials and included men. They reported similar improvements to those seen in the controlled trials.

Two of the ‘before-and-after’ studies were with patients undergoing radiotherapy [33] or chemotherapy [40]. Participants’ fatigue did not increase, and therefore art therapy may have mitigated the fatiguing effects of treatment. However, some participants in the study undergoing chemotherapy were also accessing other therapies such as massage or music therapy. It is possible that these other therapies were just as helpful as art therapy.

Qualitative research studies

There have been an additional 9 qualitative research studies, and they provided the explanations given earlier in this page about why art therapy may be helpful [19-28].

Evidence sources

1. 1. Cancer Statistics in the UK, Macmillan Cancer Support, 2024
   2. Early, medium and long-term mental health in cancer survivors compared with cancer-free comparators: matched cohort study using KU electronic health records (Forbes et al., 2024)
   3. Effectiveness of the mindfulness art therapy short version for Japanese patients with advanced cancer (Ando et al., 2016)
   4. Effectiveness of mindfulness-based art therapy on healthy quality of life in women with breast cancer (Jalambadani & Borji, 2019)
   5. Beneficial effect of mindfulness-based art therapy in patients with breast cancer – a randomized controlled trial (Jang et al., 2016)
   6. A pilot study of a mindfulness-based art therapy intervention in outpatients with cancer (Meghani et al., 2018)
   7. A randomized, controlled trial of mindfulness-based art therapy (MBAT) for women with cancer (Monti et al., 2006)
   8. Psychosocial benefits of a novel mindfulness intervention versus standard support in distressed women with breast cancer (Monti et al., 2013) 
   9. Four year follow-up of a meditation-based program for self-regulation of chronic pain: Treatment outcomes and compliance (Kabat-Zinn et al., 1987)
   10. Art therapy improves coping resources: A randomized, controlled study among women with breast cancer (Oster et al., 2006) 

   11. The efficacy of creative arts therapies to enhance emotional expression, spirituality, and psychological well-being of newly diagnosed Stage I and Stage II breast cancer patients: A preliminary study (Puig et al., 2006) 

   12. Art therapy improves experienced quality of life among women undergoing treatment for breast cancer: A randomized controlled study (Svensk et al., 2009)
   13. Individual art therapy can be helpful for women with breast cancer: A randomized controlled clinical study. Palliative and Supportive Care (Thyme et al., 2009)
   14. Impact of creative art therapy on fatigue and quality of life in patients treated for localized breast cancer: A randomized study (Joly et al., 2022)
   15. The effects of Self-Book© art therapy on cancer-related distress in female cancer patients during active treatment: A randomized controlled trial (Radl et al., 2018)
   16. The role of emotional processing in art therapy (REPAT) for breast cancer patients (Czamanski-Cohen et al., 2019)
   17. Brief, structured, group art therapy for women with breast and/or gynaecological cancer (Chan et al., 2022)
   18. Art therapy and self-image: A 5-year follow-up art therapy RCT study of women diagnosed with breast cancer (Thyme et al., 2022)
   19. Art therapy in a palliative care unit: symptom relief and perceived helpfulness in patients and their relatives (Collette et al., 2021)
   20. A Narrative View of Art Therapy and Art Making by Women with Breast Cancer (Collie et al., 2006)
   21. An innovative art therapy program for cancer patients (Deane et al., 2000)
   22. Art therapy with cancer patients during chemotherapy sessions: An analysis of the patients’ perception of helpfulness (Forzoni et al., 2010)
   23. The creative journey: A model for short-term group art therapy with posttreatment cancer patients (Luzzato et al., 2003)
   24. Art therapy for women with breast cancer: The therapeutic consequences of boundary strengthening (Oster et al., 2007)
   25. Art therapy for women with breast cancer: The therapeutic consequences of boundary strengthening (Oster et al., 2008)
   26. Women with breast cancer and gendered limits and boundaries: Art therapy as a ‘safe space’ for enacting alternative subject positions (Oster et al., 2009)
   27. Using found poetry to illuminate the existential and posttraumatic growth of women with breast cancer engaging in art therapy (Reilly et al., 2018)
   28. Art therapy’s contribution to the psychological care of adults with cancer: A survey of therapists and service users in the UK (Wood et al., 2013)
   29. Feasibility and efficacy of art therapy for Japanese cancer patients: A pilot study (Ando et al., 2013)
   30. The impact of art therapy on anxiety and hope in patients with gynecological cancer undergoing chemotherapy (Bell et al., 2022)
   31. A pilot study of improved psychological distress with art therapy in patients undergoing chemotherapy (Elimimian et al., 2020)
   32. An art therapy intervention for cancer patients in the ambulant aftercare-Results from a non-randomised controlled study (Geue et al., 2013)
   33. Art therapy using famous painting appreciation maintains fatigue levels during radiotherapy in cancer patients (Koom et al., 2016)
   34. Art therapy based on appreciation of famous paintings and its effect on distress among cancer patients. Quality of Life Research (Lee et al., 2017)
   35. Art therapy among palliative cancer patients: aesthetic dimensions and impacts on symptoms (Lefevre et al., 2016)
   36. Art therapy for terminal cancer patients in a hospice palliative care unit in Taiwan (Lin et al., 2012)
   37. Relieving Symptoms in Cancer: Innovative Use of Art Therapy (Nainis et al., 2006)
   38. Education of creative art therapy to cancer patients: Evaluation and effects (Visser & Op’t Hoog, 2008)
   39. Healing pathways: Art therapy for American Indian cancer survivors (Warson, 2012)
   40. The effect of art therapy on the quality of life in patients with a gynaecologic cancer receiving chemotherapy (Wiswell et al., 2019) 
   41. Effects of art-based mandala intervention on distress and anxiety in cancer patients (Yakar et al., 2021)