A Pilot Randomized Trial Assessing the Effect of a Psychoeducational Intervention on Psychoneuroimmunological Parameters Among Patients With Nonmetastatic Breast Cancer. Issue 2 (February 2019)

• Record Type: Journal Article
• Authors: Stanzer, Stefanie; Andritsch, Elisabeth; Zloklikovits, Silke; Ladinek, Verena; Farkas, Clemens; Augustin, Thomas; Obermayer-Pietsch, Barbara; Samonigg, Hellmut; Bauernhofer, Thomas
• Is Part Of: Psychosomatic medicine. Volume 81:Issue 2(2019)
• Publication Date: 2019-02
• Subjects: anxiety -- emotional functioning -- intrusion -- psychoeducational intervention -- regulatory T cells -- stress hormones -- ACTH = adrenocorticotropic hormone -- BCCG = breast cancer control group -- BCIG = breast cancer intervention group -- BD = blood draw -- BDI = Beck Depression Inventory -- EORTC-QLQ-C-30 = European Organization for Research and Treatment of Cancer Quality of Life Questionnaire -- HPA = hypothalamic-pituitary-adrenal axis -- IES = Impact of Event Scale -- IL = interleukin -- LTLWC = Learning to Live with Cancer -- MAC = Mental Adjustment to Cancer Scale -- NCCG = noncancer comparison group -- NK = natural killer cells -- PAF = Progression Anxiety Questionnaire -- PBMCs = peripheral blood mononuclear cells -- PNI = psychoneuroimmunology -- PQ = psychological questionnaire -- SOC = Sense of Coherence Scale -- STAI = State Trait Anxiety Inventory -- t = time point -- Tc = cytotoxic T cells -- TH = helper T cells -- Treg = regulatory T cells; Medicine, Psychosomatic -- Periodicals; 616.0805
• DOI: 10.1097/PSY.0000000000000656
• Languages: English
• ISSNs: 0033-3174

Abstract

ABSTRACT: Objective: The aim of this study was to determine a potential benefit of the specific psychoeducational intervention "Learning to Live with Cancer" (LTLWC) for patients with operated nonmetastatic breast cancer, with respect to psychological variables and endocrine and immune parameters. Methods: Fifty-two postmenopausal women with operated stage I to III breast cancer were randomized to either a breast cancer intervention group (BCIG, n = 30) who immediately began participating in the LTLWC intervention program or to a breast cancer control group (BCCG, n = 22). Matched healthy women were asked to participate as a noncancer comparison group ( n = 26). All participants were evaluated at three different time points (t1–t3) using a set of standardized questionnaires and blood samples were taken to analyze immune cell subsets and stress hormone levels. Results: A significant reduction in trait anxiety/State Trait Anxiety Inventory score was observed in the BCIG (t1: median = 35.0 [interquartile range = 28.0–38.0] versus t3: median = 26.0 [interquartile range = 18.5–37.0], p = .0001) compared with the BCCG (t1: median = 41.0 [interquartile range =32.75–49.0]; t3: median = 38.5 [interquartile range = 30.75–46.5], p = .01524; p interaction = .001). In parallel, a significant rise of serotonin levels (t1: median = 66.5 ng/ml [interquartile range = 11.50–106.00] versus t3: median = 80.5 ng/ml [interquartile range =59.00–118.00], p = .00008) as well as a significant reduction of the elevated number of Treg cells at baseline (t1: median = 4.45% [interquartile range = 4.00–5.33] versus t3: median = 2.80% [interquartile range = 2.68–3.13], p < .00001) were observed in the BCIG versus no change in the BCCG. A significant statistical association between reduced trait anxiety and decreased Treg cell number could be demonstrated in the BCIG ( r = .62, p < .01). Conclusions: The observed results of this study provide preliminary support for the efficacy of the LTLWC program in significantly improving psychoneuroimmunological parameters in patients with nonmetastatic breast cancer. Abstract : Supplemental digital content is available in the text.