A systematic review of change in symptoms, well-being and quality of life with group singing in people with cancer and their caregivers

Purpose: This systematic review aimed to assess the impact of group singing on physical function, cancer-related symptoms, well-being (emotional, physical, social, spiritual), and health-related quality of life in individuals with cancer and their caregivers. Methods: A search was performed using Ovid MEDLINE, Embase, Scopus and Web of Science from inception to April 2023; key words included cancer, choir, and group singing. Observational cohort, prospective or retrospective studies, randomized controlled studies, and crossover studies were included. Two teams of independent reviewers extracted data and assessed the risk of bias using the Downs and Black Tool. Results: A total of 6 studies (6 reports) met the inclusion criteria for this review, with a mix of study designs. The overall quality of the studies was poor. Group singing significantly reduced anxiety levels in those with cancer and their caregivers, while the effects on depression were variable and there was no impact on fatigue. Caregivers reported improved well-being, self-efficacy and self-esteem. Both those with cancer and their caregivers had reductions in fear, anger, confusion; and reported improvement in energy, relaxation and connectedness at longer term follow-up compared to no treatment. Those with cancer reported improvements in health-related quality of life domains of bodily pain, vitality and mental health with group singing, though the effects on caregivers were mixed. Conclusions: Group singing may have favourable effects on selected symptoms, aspects of well-being, and domains of health-related quality of life specific to vitality, bodily pain, and mental health in individuals with cancer and their caregivers.