Coral Gables, Fla. - Can psychological intervention help women adapt to the stresses of breast cancer? It appears that a brief, five-week psychological intervention can have beneficial effects for women who are dealing with the stresses of breast cancer diagnosis and surgery. Intervening during this early period after surgery may reduce women's distress and providing cognitive or relaxation skills for stress management may help them adapt to treatment.
University of Miami (UM) researchers found that women who received cognitive behavioral or relaxation training reported greater improvements in mood than women in a health education control group, which also lasted five weeks. Women in the cognitive behavioral group also reported reduced breast cancer-specific distress, as well as improved emotional-well-being, while women in the relaxation group reported reduced disruptions in social activities.
The next step in that research, which will be funded by the Florida Breast Cancer Foundation for a two-year period, is to identify the cellular and molecular changes that could explain these effects, according to Dr. Michael Antoni, professor in the Department of Psychology at the UM College of Arts and Sciences, and co-leader of the Cancer Prevention Control and Survivorship program at the Sylvester Comprehensive Cancer Center The grant will support Momentum2: The Breakthrough Campaign for the University of Miami.
Antoni's team hopes to show that the five-week program produces the same changes in stress hormone levels and measures of immune function and inflammatory processes over an extended follow-up period that have been seen in patients who participated in longer programs, typically from 10 weeks to 12 months. Indicators of psychological and physiological well-being may provide a pathway through which these interventions could improve quality of life and health outcomes over the long-term survivorship period, with positive effects seen as much as five years later.
The study, co-led by Dr. Bonnie Blomberg, a professor of Microbiology and Immunology at the Sylvester Comprehensive Cancer Center, will measure the changes in cortisol levels, check immune responses in cells, and look for decreased inflammation at the RNA level in cells. The new grant research, which began July 1, focuses on the women who show the most elevated levels of distress in the weeks after breast cancer surgery.
"The hope is that these psychoneuroimmunologic (PNI) effects will show us clearly how therapies like relaxation therapy can affect immune system regulation," Antoni said. "Does effective stress management reduce cortisol levels, increase immune function and decrease inflammation early in the course of women's treatment for breast cancer? We expect that women who show the greatest reductions in distress will also show the greatest reductions in inflammatory signaling and the greatest improvements in immune cell functioning over their first year of treatment."
"We know stress management is effective in a 10-week program, and women who only attended half the sessions had the same benefits, so we are testing the idea that five weeks might be enough time," he said. "The 10-week program also helped us focus on the most important things patients need to learn: being able to relax when needed and being able to cognitively process their emotions. We think we can achieve that in less than 10 weeks by using very focused interventions, and that will be more practical in a clinical setting."
"Drs. Antoni and Blomberg's project was evaluated and scored by a panel of both researchers and laypersons who are advocates for breast cancer research," said Russell Silverman, executive director of the Florida Breast Cancer Foundation. "It was recommended to our committee with great enthusiasm, and we feel that this work will have a positive impact on the future of breast cancer treatment."
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