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Biobehavioral, Immune, and Health Benefits following Recurrence for Psychological Intervention Participants
Open accessAbstract
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 (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.”
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Metadata
- 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.
- Venue
- Clinical Cancer Research
- Published
- 2010-06-14
- Volume
- 16
- Issue
- 12
- Pages
- 3270-3278
- ISSN
- 1078-0432 (ISSN-L)
- 1557-3265
- 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
- bronze
- doi.org
- 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
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › 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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