Spiritual Expression and Immune Status in Women with Metastatic Breast Cancer: An Exploratory Study
Open accessAbstract
This exploratory study examined relationships between spirituality and immune function in 112 women with metastatic breast cancer. Spirituality was assessed by patient reports of frequency of attendance at religious services and importance of religious or spiritual expression. White blood cell counts, absolute numbers of lymphocytes, T-lymphocyte subsets, and natural killer cells were assessed by flow cytometry. Assessments of natural killer cell activity and delayed-type hypersensitivity responses to skin test antigens provided two measures of functional immunity. In analyses controlling for demographic, disease status, and treatment variables, women who rated spiritual expression as more important had greater numbers of circulating white blood cells and total lymphocyte counts. Upon examination of relationships with lymphocyte subsets, both helper and cytotoxic T-cell counts were greater among women reporting greater spirituality.
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Of the 14 highest-quality immune function studies, 10 (71%) reported significant positive associations or increased immune functions in response to an R/S intervention.
“Of the 14 studies with the highest quality ratings, 10 (71%) reported significant positive associations [437–443] or increased immune functions in response to a R/S intervention [444–447].”
From Religion, Spirituality, and Health: The Research and Clinical Implications (2012) · cites this paper as [440]
Of the ten studies with quality ratings of 7 or higher, seven (70%) reported significant inverse associations with infection/viral load.
“Ten of the 12 studies had quality ratings of 7 or higher; of those, seven (70%) reported significant inverse associations with infection/viral load [440, 441, 449–454].”
From Religion, Spirituality, and Health: The Research and Clinical Implications (2012) · cites this paper as [440]
The Results and Discussion tables report associations between spiritual expression and immune measures in women with metastatic breast cancer, including an inverse association between meeting attendance and DTH response. They do not report infection or viral-load outcomes, or a quality rating for this study; searches for those terms found no supporting passage. The review-wide count of seven of ten studies also cannot be verified from this source. (LLM, conf=0.75)
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References 42 · Cited by 142
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- Authors
- Sephton, S. E., Koopman, C., Schaal, M., Thoresen, C., & Spiegel, D.
- Affiliations
- University of Louisville (US)
- Stanford University (US)
- Corresponding author
- Sephton, Sandra E.
- Venue
- The Breast Journal
- Publisher
- Hindawi Limited
- Published
- 2001-09
- Volume
- 7
- Issue
- 5
- Pages
- 345-353
- ISSN
- 1075-122X (ISSN-L)
- 1524-4741
- OpenAlex
- W2121680012
- Cited by
- 142
- References
- 42
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 45 · 2022: 2 · 2021: 2 · 2020: 1 · 2018: 5 · 2017: 4 · 2016: 4 · 2015: 4 · 2014: 2 · 2013: 5 · 2012: 7
- FWCI
- 5.07
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Breast Journal (publishedVersion)
- PubMed (publishedVersion)
- Funders
- John D. and Catherine T. MacArthur Foundation
- Fetzer Institute
- National Institute of Mental Health (MH47226, R01MH047226)
- National Cancer Institute
- Topics
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Psychiatry and Mental health › Cancer, Stress, Anesthesia, and Immune Response
- Keywords
- spirituality, metastatic breast cancer, immune function, white blood cell count, lymphocyte subsets, T cell subsets, natural killer cells, delayed-type hypersensitivity, religious service attendance, women
- MeSH terms
- Breast Neoplasms, Female, Flow Cytometry, Humans, Middle Aged, Neoplasm Metastasis, Prospective Studies, Psychotherapy, Social Support, Karnofsky Performance Status, Lymphocyte Count, Spirituality
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