Journal article
Stress management, leukocyte transcriptional changes and breast cancer recurrence in a randomized trial: An exploratory analysis
Psychoneuroendocrinology, Vol.74, pp.269-277
12/2016
DOI: 10.1016/j.psyneuen.2016.09.012
PMCID: PMC5159236
PMID: 27689900
Abstract
•Conserved transcriptional response to adversity (CTRA) rises with cancer treatment.•Cognitive behavioral stress management (CBSM) buffers CTRA during treatment.•Less CTRA rise during cancer treatment predicts longer 11-yr disease-free survival.•CBSM modulates disease relevant biobehavioral processes in breast cancer treatment.
Cognitive behavioral stress management (CBSM) is an empirically-validated group-based psychosocial intervention. CBSM is related to decreased self-reported indicators of psychological adversity during breast cancer treatment and greater disease-free survival (DFS) vs. a control condition. This study examined relationships between CBSM, DFS, and a potential biobehavioral pathway linking these variables in breast cancer patients through a gene expression composite representing the leukocyte conserved transcriptional response to adversity (CTRA).
Women with stage 0-IIIb breast cancer completed questionnaires and provided blood samples post-surgery. Participants were randomized to 10-week group-based CBSM or a psychoeducation control group and followed at 6 months, 12 months, and median 11 years. In total, 51 participants provided blood data for longitudinal analyses (CBSM n=28; Control n=23). Mixed model analyses examined CBSM effects on 6–12 month changes in CTRA expression (53 indicator genes representing pro-inflammatory, anti-viral and antibody production signaling). Cox regression models assessed the relationship between 6 and 12 month changes in CTRA expression and 11-year DFS.
Patients randomized to CBSM showed attenuated 6–12 month change in CTRA gene expression, whereas patients randomized to control showed increased CTRA expression (p=0.014). Average DFS was 5.92 years (SD=3.90). Greater 6–12 month CTRA increases predicted shorter 11-year DFS controlling for covariates (p=0.007).
CBSM attenuated CTRA gene expression during the initial year of breast cancer treatment. In turn, greater increases in CTRA gene expression predicted shorter long-term DFS. These findings identify a biobehavioral oncology pathway to examine in future work.
Details
- Title: Subtitle
- Stress management, leukocyte transcriptional changes and breast cancer recurrence in a randomized trial: An exploratory analysis
- Creators
- Michael H Antoni - Dept. of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL 33124, USALaura C Bouchard - Dept. of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL 33124, USAJamie M Jacobs - Center for Psychiatric Oncology and Behavioral Sciences, Dept. of Psychiatry, Massachusetts General Hospital Cancer Center, 55 Fruit St., Boston, MA 02114, USASuzanne C Lechner - Dept. of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St., Miami, FL 33136, USADevika R Jutagir - Dept. of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL 33124, USALisa M Gudenkauf - Dept. of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL 33124, USACharles S Carver - Dept. of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Coral Gables, FL 33124, USASusan Lutgendorf - Dept. of Psychological and Brain Sciences, University of Iowa, E 11 Seashore Hall, Iowa City, IA 52242, USASteven W Cole - Dept. of Medicine, Division of Hematology-Oncology, University of California – Los Angeles School of Medicine, 11-934 Factor Bldg, Los Angeles, CA 90095, USAMarc Lippman - Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1475 NW 12th Ave., Miami, FL 33136, USABonnie B Blomberg - Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1475 NW 12th Ave., Miami, FL 33136, USA
- Resource Type
- Journal article
- Publication Details
- Psychoneuroendocrinology, Vol.74, pp.269-277
- DOI
- 10.1016/j.psyneuen.2016.09.012
- PMID
- 27689900
- PMCID
- PMC5159236
- NLM abbreviation
- Psychoneuroendocrinology
- ISSN
- 0306-4530
- eISSN
- 1873-3360
- Publisher
- Elsevier BV
- Grant note
- DOI: 10.13039/100000054, name: National Cancer Institute; DOI: 10.13039/100000002, name: National Institutes of Health, award: HHSN261200800001E; name: NCI, award: R01CA064710
- Language
- English
- Date published
- 12/2016
- Academic Unit
- Psychological and Brain Sciences; Iowa Neuroscience Institute; Obstetrics and Gynecology; Urology
- Record Identifier
- 9984002346602771
Metrics
19 Record Views