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Cited by 158Cancer survivorship and careCancer, Stress, Anesthesia, and Immune ResponseWomen's cancer prevention and management

Biobehavioral, immune, and health benefits following recurrence for psychological intervention participants

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Andersen, Barbara L., Thornton, Lisa M., Shapiro, Charles L., Farrar, William B., Mundy, Bethany L., Yang, Hae-Chung, Carson, William E.·2010·Clinical Cancer Research
DOI 10.1158/1078-0432.ccr-10-0278PMC PMC2910547
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Abstract

Purpose: A clinical trial was designed to test the hypothesis that a psychological intervention could reduce the risk of cancer recurrence. Newly diagnosed regional breast cancer patients (n = 227) were randomized to the intervention-with-assessment or the assessment-only arm. The intervention had positive psychological, social, immune, and health benefits, and after a median of 11 years the intervention arm was found to have reduced the risk of recurrence (hazard ratio, 0.55; P = 0.034). In follow-up, we hypothesized that the intervention arm might also show longer survival after recurrence. If observed, we then would examine potential biobehavioral mechanisms. Experimental Design: All patients were followed; 62 recurred. Survival analyses included all 62. Upon recurrence diagnosis, those available for further biobehavioral study were accrued (n = 41, 23 intervention and 18 assessment). For those 41, psychological, social, adherence, health, and immune (natural killer cell cytotoxicity, T-cell proliferation) data were collected at recurrence diagnosis and 4, 8, and 12 months later. Results: Intent-to-treat analysis revealed reduced risk of death following recurrence for the intervention arm (hazard ratio, 0.41; P = 0.014). Mixed-effects follow-up analyses with biobehavioral data showed that all patients responded with significant psychological distress at recurrence diagnosis, but thereafter only the intervention arm improved (P values < 0.023). Immune indices were significantly higher for the intervention arm at 12 months (P values < 0.017). Conclusions: Hazards analyses augment previous findings in showing improved survival for the intervention arm after recurrence. Follow-up analyses showing biobehavioral advantages for the intervention arm contribute to our understanding of how improved survival was achieved. Clin Cancer Res; 16(12); 3270–8. ©2010 AACR.

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  • Previous research suggests that cancer patients with higher distress or depressive symptoms, or elevated sleep disturbance, derive greater benefit from psychosocial or behavioural interventions.

    “previous research suggests that cancer patients with higher distress or depressive symptoms (Andersen et al., 2010;Antoni et al., 2001;Danhauer et al., 2009), or elevated sleep disturbance (Ratcliff et al., 2016), derive greater benefit from psychosocial or behavioural interventions.”

    From The effects of physical activity on cortisol and sleep: A systematic review and meta-analysis. (2022) · cites this paper as Andersen et al., 2010

    The Results (Biobehavioral Analyses; page unavailable) report that both study arms had high negative mood after breast cancer recurrence, but distress subsequently declined only in the intervention arm. This supports a benefit among distressed patients, but the paper does not show that patients with higher distress or depressive symptoms benefited more than patients with lower levels. The sleep-disturbance clause is attributed to a different citation. (LLM, conf=0.82)

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  1. [35]Taketomi A Shimada M Shirabe K Kajiyama K Gion T Sugimachi K Natural killer cell activity in patients with hepatocellular carcinoma: A new prognostic indicator after hepatectomy Cancer 1998 83 1 58 63 9655293

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Authors
Andersen, B. L., Thornton, L. M., Shapiro, C. L., Farrar, W. B., Mundy, B. L., Yang, H.-C., & Carson, W. E.
Affiliations
  • The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (US)
  • Authors' Affiliations: 1Department of Psychology, and 2Department of Surgery, 3Comprehensive Cancer Center and the Solove Research Institute, and 4Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio
Corresponding author
Andersen, Barbara L.
ORCID
Venue
Clinical Cancer Research
Publisher
American Association for Cancer Research (AACR)
Published
2010-06-14
Volume
16
Issue
12
Pages
3270-3278
ISSN
  • 1078-0432 (ISSN-L)
  • 1557-3265
DOI
10.1158/1078-0432.ccr-10-0278
PMC
PMC2910547
OpenAlex
W2161805825
Cited by
158
References
64
Citations by year
2026: 2 · 2025: 1 · 2024: 4 · 2023: 5 · 2022: 19 · 2021: 12 · 2020: 7 · 2019: 15 · 2018: 16 · 2017: 14 · 2016: 7 · 2015: 14 · 2014: 15 · 2013: 8 · 2012: 11
FWCI
4.27
Type
journal article
Language
en
Open access
Locations
  • Clinical Cancer Research (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute of Mental Health (R01MH51487, R01MH051487)
  • National Cancer Institute (P-30-CA-16058, R01CA092704, R01 CA 92704, K05CA098133, P30CA016058)
  • National Center for Research Resources (UL1RR025755)
Topics
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Medicine › Psychiatry and Mental health › Cancer, Stress, Anesthesia, and Immune Response
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
Keywords
breast cancer recurrence, psychological intervention, survival after recurrence, psychological distress, NK cell cytotoxicity, T cell proliferation, immune function, biobehavioral mechanisms, medication adherence, social support
MeSH terms
Behavior, Breast Neoplasms, Female, Humans, Insurance Benefits, Killer Cells, Natural, Middle Aged, Neoplasm Recurrence, Local, Psychotherapy, Recurrence, Survival Analysis

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