Social influences on clinical outcomes of patients with ovarian cancer
Open accessAbstract
Purpose: Previous research has demonstrated relationships of social support with disease-related biomarkers in patients with ovarian cancer. However, the clinical relevance of these findings to patient outcomes has not been established. This prospective study examined how social support relates to long-term survival among consecutive patients with ovarian cancer. We focused on two types of social support: social attachment, a type of emotional social support reflecting connections with others, and instrumental social support reflecting the availability of tangible assistance. Patients and Methods: Patients were prospectively recruited during a presurgical clinic visit and completed surveys before surgery. One hundred sixty-eight patients with histologically confirmed epithelial ovarian cancer were observed from the date of surgery until death or December 2010. Clinical information was obtained from medical records. Results: In a Cox regression model, adjusting for disease stage, grade, histology, residual disease, and age, greater social attachment was associated with a lower likelihood of death (hazard ratio [HR], 0.87; 95% CI, 0.77 to 0.98; P = .018). The median survival time for patients with low social attachment categorized on a median split of 15 was 3.35 years (95% CI, 2.56 to 4.15 years). In contrast, by study completion, 59% of patients with high social attachment were still alive after 4.70 years. No significant association was found between instrumental social support and survival, even after adjustment for covariates. Conclusion: Social attachment is associated with a survival advantage for patients with ovarian cancer. Clinical implications include the importance of screening for deficits in the social environment and consideration of support activities during adjuvant treatment.
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Social isolation, stress, and depression are linked to biological processes that drive tumor progression and lower survival.
“Additionally, factors such as social isolation, stress, and depression are associated with key biological processes promoting tumor progression and poorer survival.”
From Living Well: Protocol for a web-based program to improve quality of life in rural and urban ovarian cancer survivors (2024) · cites this paper as [14]
The Introduction (page unavailable) links low social support and depressive symptoms to tumor biomarkers, while the Discussion describes stress-response pathways that may promote tumor growth. The study also associates lower social attachment with poorer survival, but its survival analysis found that neither past nor current major depression significantly predicted survival; it does not establish that the proposed biological pathways mediated survival. (LLM, conf=0.85)
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Self-citationRentscher, K. E., Zhou, X., Small, B. J., Cohen, H. J., Dilawari, A. A., Patel, S. K., Bethea, T. N., Dyk, K. V., Nakamura, Z. M., Ahn, J., et al. (2021) · Cancer · doi:10.1002/cncr.33687 · Cited by 82 · see citing works
Forsythe, L. P., Alfano, C. M., Kent, E. E., Weaver, K. E., Bellizzi, K. M., Arora, N. K., Aziz, N. M., Keel, G., & Rowland, J. H. (2014) · Psycho-Oncology · doi:10.1002/pon.3480 · Cited by 81 · see citing works
“, perceived acceptance, empathy, assistance with coping) [5,6], is widely acknowledged as beneficial for health after cancer, including psychological adaptation [7–10], quality of life [11–13], and, in some cases, survival [14,15].”
BackgroundUslu-Sahan, F., Terzioglu, F., & Koc, G. (2019) · Cancer Nursing · doi:10.1097/ncc.0000000000000622 · Cited by 68 · see citing works
“Social support has been defined as the assistance and protection given to others, especially to individuals,(7) and has a positive impact on health outcomes in patients with gynecologic cancer(9,10,23,24) and quality of life(4,10); it can help patients adapt to the disease and treatment process(5,9,15,23,24) and may e…”
BackgroundBeattie, S., Lebel, S., & Tay, J. (2013) · PLoS ONE · doi:10.1371/journal.pone.0061586 · Cited by 65 · see citing works
“found that amongst women with ovarian cancer, those with higher social attachment had a survival advantage whereas patient survival was not associated with level of instrumental support [21].”
BackgroundStress, inflammation, and eicosanoids: an emerging perspective
Umamaheswaran, S., Dasari, S. K., Yang, P., Lutgendorf, S. K., & Sood, A. K. (2018) · Cancer and Metastasis Reviews · doi:10.1007/s10555-018-9741-1 · Cited by 64 · see citing works
Self-citationBehavioral Research in Cancer Prevention and Control
Klein, W. M. P., Bloch, M., Hesse, B. W., McDonald, P. G., Nebeling, L. C., O’Connell, M. E., Riley, W. T., Taplin, S. H., & Tesauro, G. (2014) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2013.10.004 · Cited by 62 · see citing works
“Research on relationship processes demonstrates that social support and intimate relationships buffer the effects of stress on health,(53) and cancer survivors depend greatly on, and benefit from, social support.(54,55) Less is known about how relationships influence everyday behaviors (e.”
BackgroundLinks between inflammation, amygdala reactivity, and social support in breast cancer survivors
Muscatell, K. A., Eisenberger, N. I., Dutcher, J. M., Cole, S. W., & Bower, J. E. (2015) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2015.09.008 · Cited by 60 · see citing works
“Growing evidence indicates that social isolation is associated with activation of inflammatory processes (Cole et al., 2015), and greater social support has been shown to predict survival in women with breast (Kroenke et al., 2006) and ovarian cancer (Lutgendorf et al., 2005; 2012).”
BackgroundSelf-citationOvarian cancer outcomes: Predictors of early death
Urban, R. R., He, H., Alfonso, R., Hardesty, M. M., Gray, H. J., & Goff, B. A. (2015) · Gynecologic Oncology · doi:10.1016/j.ygyno.2015.12.021 · Cited by 61 · see citing works
Psychological distress and eustress in cancer and cancer treatment: Advances and perspectives
Wu, Y., Zhou, L., Zhang, X., Yang, X., Niedermann, G., & Xue, J. (2022) · Science Advances · doi:10.1126/sciadv.abq7982 · Cited by 63 · see citing works
“Social support may be related to a lower risk of breast and ovarian cancer and better prognosis of patients with cancer (11, 12).”
BackgroundBiobehavioral Pathways and Cancer Progression: Insights for Improving Well-Being and Cancer Outcomes
Chang, A., Sloan, E. K., Antoni, M. H., Knight, J. M., Telles, R., & Lutgendorf, S. K. (2022) · Integrative Cancer Therapies · doi:10.1177/15347354221096081 · Cited by 59 · see citing works
Self-citationInternet-Based Group Intervention for Ovarian Cancer Survivors: Feasibility and Preliminary Results
Kinner, E. M., Armer, J. S., McGregor, B. A., Duffecy, J., Leighton, S., Corden, M. E., Gauthier Mullady, J., Penedo, F. J., & Lutgendorf, S. K. (2018) · JMIR Cancer · doi:10.2196/cancer.8430 · Cited by 51 · see citing works
“Numerous studies have identified links between psychological processes and biological pathways related to ovarian cancer progression [9,10].”
BackgroundSelf-citationPrice, M., Bell, M. L., Sommeijer, D. W., Friedlander, M. L., Stockler, M. R., DeFazio, A., Webb, P. M., & Butow, P. N. (2013) · Gynecologic Oncology · doi:10.1016/j.ygyno.2013.03.031 · Cited by 56 · see citing works
“Recent evidence suggests that social support, in particular social attachment, is associated with longer survival [11].”
BackgroundDiurnal cortisol rhythms, fatigue and psychosocial factors in five-year survivors of ovarian cancer
Cuneo, M. G., Schrepf, A., Slavich, G. M., Thaker, P. H., Goodheart, M., Bender, D., Cole, S. W., Sood, A. K., & Lutgendorf, S. K. (2017) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2017.06.019 · Cited by 55 · see citing works
“We chose to examine social attachment, as opposed to other facets of social relationship support (e.g. instrumental social support), because social attachment has been most linked to biological processes in previous research (Lutgendorf et al., 2012).”
Self-citationMinding the body: Psychotherapy and cancer survival
Spiegel, D. (2014) · British Journal of Health Psychology · doi:10.1111/bjhp.12061 · Cited by 53 · see citing works
Ehrlich, K. B., Miller, G. E., Scheide, T., Baveja, S., Weiland, R., Galvin, J. P., Mehta, M. P., & Penedo, F. J. (2016) · Bone Marrow Transplantation · doi:10.1038/bmt.2016.191 · Cited by 54 · see citing works
Self-citationPrometastatic Molecular Profiles in Breast Tumors From Socially Isolated Women
Bower, J. E., Shiao, S. L., Sullivan, P., Lamkin, D. M., Atienza, R., Mercado, F., Arevalo, J. M. G., Asher, A., Ganz, P. A., & Cole, S. W. (2018) · JNCI Cancer Spectrum · doi:10.1093/jncics/pky029 · Cited by 55 · see citing works
“sample of women recently diagnosed with ovarian cancer (median 1⁄4 15) (34).”
Self-citationWen, Q., Shao, Z., Zhang, P., Zhu, T., Li, D., & Wang, S. (2017) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2017.07.004 · Cited by 53 · see citing works
Levin, N. J., Zebrack, B., & Cole, S. W. (2019) · Pediatric Blood & Cancer · doi:10.1002/pbc.27789 · Cited by 55 · see citing works
“24, 25, 26 Analyses of tumor tissues from such patients have found increased expression of a wide array of genes involved in inflammation, blood vessel growth, and metastasis, as well as reduced expression of genes involved in anti-tumor immune responses.”
BackgroundSelf-citationOrlewska, K., Śliwczyński, A. M., & Orlewska, E. (2018) · International Journal of Public Health · doi:10.1007/s00038-018-1082-x · Cited by 52 · see citing works
PTSD symptoms as a consequence of breast cancer diagnosis: clinical implications
Arnaboldi, P., Lucchiari, C., Santoro, L., Sangalli, C., Luini, A., & Pravettoni, G. (2014) · SpringerPlus · doi:10.1186/2193-1801-3-392 · Cited by 52 · see citing works
“In particular, avoidant reactions seem to be more associated with poorer physical health while intrusive reactions seem to be related to poorer psychological health (Lutgendorf et al. 2012).”
BackgroundHill, E. M. (2015) · Psychology Health & Medicine · doi:10.1080/13548506.2015.1109674 · Cited by 47 · see citing works
“Furthermore, social attachment was recently linked to an increased probability of survival among ovarian cancer patients, even after controlling for depression (Lutgendorf et al., 2012).”
BackgroundCox, A., & Faithfull, S. (2015) · Supportive Care in Cancer · doi:10.1007/s00520-014-2578-4 · Cited by 45 · see citing works
“To date, this is unexplored in women following treatment for ovarian cancer, but there is a suggestion that social support is associated with a survival advantage [19].”
BackgroundQuality of life across chemotherapy lines in patients with cancers of the pancreas and biliary tract
Zabernigg, A. F., Giesinger, J. M., Pall, G., Gamper, E., Gattringer, K. B., Wintner, L. M., Sztankay, M. J., & Holzner, B. (2012) · BMC Cancer · doi:10.1186/1471-2407-12-390 · Cited by 45 · see citing works
“Besides treatment possibilities, high socioeconomic status also has been found to influence overall cancer survival positively [27,28] and social support was linked to cancer survival as well, although the results are divergent [29].”
Resulton behalf of the Australian National Endometrial Cancer Study Group, Rowlands, I. J., Janda, M., McKinnon, L., Webb, P. M., & Beesley, V. L. (2014) · Supportive Care in Cancer · doi:10.1007/s00520-014-2456-0 · Cited by 45 · see citing works
“Social support has also been associated with increased quality of life [24] and also possibly cancer survival [22].”
Lutgendorf, S. K., Shinn, E. H., Carter, J., Leighton, S. L., Baggerly, K., Guindani, M., Fellman, B. M., Matzo, M. L., Slavich, G. M., Goodman, M. T., et al. (2017) · Gynecologic Oncology · doi:10.1016/j.ygyno.2017.05.008 · Cited by 45 · see citing works
Self-citationSocial support and outcomes in older adults with lung cancer
Chambers, A., Damone, E., Chen, Y. T., Nyrop, K. A., Deal, A. M., Muss, H. B., & Charlot, M. (2021) · Journal of Geriatric Oncology · doi:10.1016/j.jgo.2021.09.009 · Cited by 43 · see citing works
Predictors of survival trajectories among women with epithelial ovarian cancer
Peres, L. C., Sinha, S., Townsend, M. K., Fridley, B. L., Karlan, B. Y., Lutgendorf, S. K., Shinn, E. H., Sood, A. K., & Tworoger, S. S. (2019) · Gynecologic Oncology · doi:10.1016/j.ygyno.2019.12.011 · Cited by 41 · see citing works
“The role of social support in outcomes of ovarian cancer patients has been some-what mixed [40–42], although higher levels of emotional support or social attachment have been linked to better survival [41].”
BackgroundSelf-citationNorepinephrine-Induced DNA Damage in Ovarian Cancer Cells
Lamboy-Caraballo, R., Ortíz, C., Acevedo‐Santiago, A., Matta, J. L., Monteiro, Á. N. A., & Armaiz-Peña, G. N. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21062250 · Cited by 41 · see citing works
“Notably, a significant number of EOC patients lack social support, are clinically depressed, or exhibit anxiety disorders [4,10,11].”
BackgroundThe impact of social and environmental factors on cancer biology in Black Americans
Lord, B. D., Harris, A. R., & Ambs, S. (2022) · Cancer Causes & Control · doi:10.1007/s10552-022-01664-w · Cited by 40 · see citing works
“This extends to individuals living with cancer, where an adverse social environment, including social isolation, has been repeatedly associated with reduced survival across multiple cancer types [123, 124].”
BackgroundVITALIANO, P. P., Strachan, E. D., Dansie, E. J., Goldberg, J. H., & Buchwald, D. (2013) · Annals of Behavioral Medicine · doi:10.1007/s12160-013-9538-y · Cited by 38 · see citing works
“This is true for caregivers of people with dementias [7], psychiatric illnesses [8], cancer [9, 10], coronary events [11], AIDS [5], and autism [12].”
BackgroundCentral and peripheral nervous systems: master controllers in cancer metastasis
Shi, M., Liu, D., Yang, Z., & Guo, N. (2013) · Cancer and Metastasis Reviews · doi:10.1007/s10555-013-9440-x · Cited by 38 · see citing works
“Opposite conclusions were also reached [156–161].”
Yağmur, Y., & Duman, M. (2016) · International Journal of Gynecology & Obstetrics · doi:10.1016/j.ijgo.2015.12.010 · Cited by 37 · see citing works
“The loss or dysfunction of body parts related to sexual identity increases the social support needs of women with gynecologic cancer more as compared with patients with other types of cancer [11].”
BackgroundJenkins, V. A., Catt, S., Banerjee, S. N., Gourley, C., Montes, A., Solis‐Trapala, I., Monson, K., & Fallowfield, L. J. (2013) · British Journal of Cancer · doi:10.1038/bjc.2013.223 · Cited by 36 · see citing works
Biobehavioral modulation of the exosome transcriptome in ovarian carcinoma
Lutgendorf, S. K., Thaker, P. H., Arevalo, J. M., Goodheart, M. J., Slavich, G. M., Sood, A. K., & Cole, S. W. (2018) · Cancer · doi:10.1002/cncr.31078 · Cited by 34 · see citing works
“Exosomal signaling enables long-range communication between cells within an organism, and this suggests that exosomal signaling may provide an additional pathway by which biobehavioral processes can influence a cancer’s biology and treatment response.(19) There is a substantial literature linking biobehavioral factors…”
Self-citationSociocognitive Functioning and Psychosocial Burden in Patients with Brain Tumors
Pertz, M., Schlegel, U. S., & Thoma, P. (2022) · Cancers · doi:10.3390/cancers14030767 · Cited by 34 · see citing works
Sympathetic nerve signaling rewires the tumor microenvironment: a shift in “microenvironmental-ity”
Sattler, A. L., Korzun, T., Gupta, K., Diba, P., Kyprianou, N., & Eksi, S. (2025) · Cancer Metastasis Review · doi:10.1007/s10555-025-10241-x · Cited by 38 · see citing works
“There is strong evidence that patients who effectively manage stress have better prognoses compared with those experiencing higher levels of stress [117].”
Screening of psychological distress in cancer patients during chemotherapy: A cross-sectional study
Singh, H., Singh, R. B., Singh, C., & Kaur, K. (2015) · Indian Journal of Palliative Care · doi:10.4103/0973-1075.164887 · Cited by 32 · see citing works
Schuurhuizen, C. S. E. W., Braamse, A. M. J., Beekman, A. T. F., Cuijpers, P. J., van der Linden, M. H. M., Hoogendoorn, A. W., Berkhof, J. H., Sommeijer, D. W., Lustig, V., Vrijaldenhoven, S., et al. (2019) · Journal of the National Comprehensive Cancer Network · doi:10.6004/jnccn.2019.7285 · Cited by 30 · see citing works
Social Integration, Marital Status, and Ovarian Cancer Risk: A 20-Year Prospective Cohort Study
Trudel‐Fitzgerald, C., Poole, E. M., Sood, A. K., Okereke, O. I., Kawachi, I. I., Kubzansky, L. D., & Tworoger, S. S. (2019) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000747 · Cited by 29 · see citing works
Self-citationThe Association of Work Characteristics With Ovarian Cancer Risk and Mortality
Trudel‐Fitzgerald, C., Poole, E. M., Idahl, A., Lundin, E., Sood, A. K., Kawachi, I. I., Kubzansky, L. D., & Tworoger, S. S. (2017) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000464 · Cited by 26 · see citing works
“Observational data on depression and lower social support also suggested relationships with biomarkers of worse OvCA prognosis or reduced survival (14,16).”
BackgroundSelf-citationChenevix‐Trench, G., Price, M. A., Butow, P. N., Bell, M. L., DeFazio, A., Friedlander, M. L., Fardell, J. E., Protani, M. M., & Webb, P. M. (2016) · Supportive Care in Cancer · doi:10.1007/s00520-015-3070-5 · Cited by 27 · see citing works
Psychological stress and cancer: new evidence of an increasingly strong link
Martinelli, R. (2020) · Translational Medicine UniSa · doi:10.37825/2239-9747.1010 · Cited by 25 · see citing works
“and activator of transcription 3 (STAT3), the prolactin hormone and the prostaglandin E2 (PGE2) synthesis, all known to promote proliferation, migration, angiogenesis and apoptosis evasion in several cancers [2-5, 23-25].”
BackgroundNon-cancer life stressors contribute to impaired quality of life in ovarian cancer patients
Lutgendorf, S. K., Slavich, G. M., Degeest, K., Goodheart, M. J., Bender, D., Thaker, P. H., Penedo, F. J., Zimmerman, B. M., Lucci, J. A., Méndez, L., et al. (2013) · Gynecologic Oncology · doi:10.1016/j.ygyno.2013.09.025 · Cited by 25 · see citing works
“Inclusionwas confirmed by histologic diagnosis with primary invasive epithelial ovarian, primary peritoneal, or primary fallopian tube cancer as part of a larger study examining biobehavioral factors and QOL in ovarian cancer [22].”
BackgroundSelf-citationLutgendorf, S. K., Penedo, F. J., Goodheart, M. J., Dahmoush, L., Arevalo, J. M. G., Thaker, P. H., Slavich, G. M., Sood, A. K., & Cole, S. W. (2020) · Cancer · doi:10.1002/cncr.33060 · Cited by 26 · see citing works
Self-citationPrescott, L. S., Dickens, A. S., Guerra, S. L., Tanha, J., Phillips, D. G., Patel, K. T., Umberson, K. M., Lozano, M. A., Lowe, K. B., Brown, A. J., et al. (2015) · Gynecologic Oncology · doi:10.1016/j.ygyno.2015.11.006 · Cited by 24 · see citing works
“Integrating social networks into cancer treatment delivery is essential to improving patient care and quality of life [3].”
BackgroundAlimujiang, A., Khoja, L., Wiensch, A., Pike, M. C., Webb, P. M., Chenevix‐Trench, G., Chase, A., Richardson, J. L., & Pearce, C. L. (2019) · Gynecologic Oncology · doi:10.1016/j.ygyno.2019.10.007 · Cited by 24 · see citing works
Lowery, W. J., Stany, M. P., Phippen, N. T., Bunch, K. P., Oliver, K., Tian, C., Maxwell, G. L., Darcy, K. M., & Hamilton, C. A. (2014) · Gynecologic Oncology · doi:10.1016/j.ygyno.2014.12.027 · Cited by 24 · see citing works
“The extreme vulnerability of widows might be explained by the fact that they likely have low social attachment scores, a feature associated with poor survival in ovarian cancer patients regardless of relationship status [36].”
BackgroundKoh‐Bell, A., Chan, J. E., Mann, A. K., & Kapp, D. S. (2021) · BMC Public Health · doi:10.1186/s12889-021-11352-0 · Cited by 24 · see citing works
Targeting those with decreased meaning and peace: a supportive care opportunity
Brown, A. J., Sun, C. C., Urbauer, D. L., Zhukovsky, D. S., Levenback, C., Frumovitz, M., Thaker, P. H., Bodurka, D. C., & Ramondetta, L. M. (2014) · Supportive Care in Cancer · doi:10.1007/s00520-014-2568-6 · Cited by 22 · see citing works
“improved social relationships may improve overall survival through the alteration of the tumor microenvironment [31, 32].”
Self-citationLelorain, S., Cortot, A. B., Christophe, V., Pinçon, C., & Gidron, Y. (2018) · Journal of Clinical Medicine · doi:10.3390/jcm7100364 · Cited by 22 · see citing works
“Related to empathy, the role of social support in survival, including cancer survival, has been established [7,8].”
BackgroundJatoi, A., Muss, H. B., Allred, J., Cohen, H. J., Ballman, K. V., Hopkins, J. O., Gajra, A., Lafky, J. M., Wolff, A. C., Kottschade, L. A., et al. (2015) · Psycho-Oncology · doi:10.1002/pon.3850 · Cited by 20 · see citing works
“In contrast to our findings, Lutgendorf and others examined 168 ovarian cancer patients, who admittedly were contending with a more advanced and lethal malignancy [2].”
BackgroundResultAlobaidi, A., Nabulsi, N., Talon, B., Asfaw, A. A., Zhou, J.-F., Sharp, L., Sweiss, K., Patel, P., Chiu, B., Ko, N., et al. (2019) · Supportive Care in Cancer · doi:10.1007/s00520-019-05246-6 · Cited by 19 · see citing works
Why stress is BAD for cancer patients
Nagaraja, A. S., Armaiz-Peña, G. N., Lutgendorf, S. K., & Sood, A. K. (2013) · Journal of Clinical Investigation · doi:10.1172/jci67887 · Cited by 18 · see citing works
Self-citationCancer Prevention During Early Adulthood: Highlights From a Meeting of Experts
Holman, D. M., White, M. C., Shoemaker, M. L., Massetti, G. M., Puckett, M., & Brindis, C. D. (2017) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2017.04.020 · Cited by 20 · see citing works
“September 2017 protection of cancer cells from anoikis (a form of programmed cell death), increased nerve density, and altered tumor microenvironment; these mechanisms collectively can lead to poorer cancer outcomes.(35,36) Chronic inflammation may mediate the observed relationship between stressors such as social iso…”
BackgroundMaher, C., & Mendonca, R. J. (2018) · American Journal of Occupational Therapy · doi:10.5014/ajot.2018.023663 · Cited by 19 · see citing works
Kanesvaran, R., Wang, W., Yang, Y., Wei, Z., Jia, L., Li, F., Wu, S., Bai, C., Xie, H., Zhang, H., et al. (2014) · Journal of Geriatric Oncology · doi:10.1016/j.jgo.2014.01.004 · Cited by 18 · see citing works
“Studies have also shown close links between social support and survival in patients with cancer.(20) As such it will be”
BackgroundThe impact of social-emotional context in chronic cancer pain: patient-caregiver reverberations
Laurentis, M. D., Botto, R., Bovero, A., Riccardo, T., & Ieraci, V. (2018) · Supportive Care in Cancer · doi:10.1007/s00520-018-4530-5 · Cited by 18 · see citing works
Psychosocial factors and mortality in women with early stage endometrial cancer
Telepak, L. C., Jensen, S. E., Dodd, S. M., Morgan, L. S., & Pereira, D. B. (2013) · British Journal of Health Psychology · doi:10.1111/bjhp.12070 · Cited by 18 · see citing works
“In gynaecologic cancer populations, specifically ovarian cancer, better quality of life (Carey et al., 2008) and higher social attachment, a type of emotional support (Lutgendorf et al., 2012), are associated with longer survival times.”
BackgroundResultInfluentialPreserving Oneself in the Face of Uncertainty: A Grounded Theory Study of Women With Ovarian Cancer
Pozzar, R. A., & Berry, D. L. (2019) · Oncology nursing forum · doi:10.1188/19.onf.595-603 · Cited by 18 · see citing works
Online Social Networks - Opportunities for Empowering Cancer Patients
Mohammadzadeh, Z., Davoodi, S., & Ghazisaeidi, M. (2016) · Asian Pacific Journal of Cancer Prevention · doi:10.7314/apjcp.2016.17.3.933 · Cited by 17 · see citing works
“Studies show that providing different supportive activities through social networks may be able to increase survival rate and decrease mortality, disabilities and recurrence in cancer patients (Vogt et al., 1992; Kroenke et al., 2006; Lutgendorf et al., 2012).”
BackgroundPsychosocial interventions for ovarian cancer survivors: A systematic review
Yeoh, S. A., Webb, S., Phillips, A., Li, L. S. K., & Kumar, S. (2024) · Psycho-Oncology · doi:10.1002/pon.6280 · Cited by 17 · see citing works
“9,10 According to Lutgendorf and Sood, 9 addressing psychosocial conditions of perceived stress, distress and loneliness through psychosocial support may delay cancer progression.”
BackgroundInfluentialCuneo, M. G., Szeto, A., Schrepf, A., Kinner, E. M., Schachner, B. I., Ahmed, R., Thaker, P. H., Goodheart, M., Bender, D., Cole, S. W., et al. (2019) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2019.04.007 · Cited by 18 · see citing works
“While these studies are typically examining centrally released oxytocin, relationships between tumor microenvironment oxytocin and psychosocial factors should be investigated as both social isolation and stress have been linked to disease processes in ovarian cancer (Cole and Sood, 2012; Lutgendorf et al., 2012; Lutge…”
BackgroundSelf-citationImportance of adrenergic pathways in women's cancers
Thaker, P. H., Sood, A. K., & Ramondetta, L. M. (2013) · Cancer Biomarkers · doi:10.3233/cbm-130324 · Cited by 16 · see citing works
“This study highlights the importance of support activities during adjuvant therapy and how social support may act as stress buffer which leads to decreased adrenergic effects on the tumor [42].”
Self-citationTraumatic brain injury and neuro-endocrine disruption: Medical and psychosocial rehabilitation
Webb, N. E., Little, B., Loupee-Wilson, S., & Power, E. (2014) · Neurorehabilitation · doi:10.3233/nre-141074 · Cited by 17 · see citing works
““Psychosocial” stressors threaten neuroendocrine integrity, and visa versa – and they do so at a cellular and structural level (Lutgendorf et al., 2009, 2012; Miller et al., 1997, 2009; Piazza et al., 2013).”
Social vulnerability is associated with increased postoperative morbidity following esophagectomy
Stuart, C. M., Dyas, A. R., Byers, S., Velopulos, C. G., Randhawa, S. K., David, E. A., Pritap, A., Stewart, C. L., Mitchell, J. D., McCarter, M. D., et al. (2023) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/j.jtcvs.2023.04.027 · Cited by 15 · see citing works
Chirico, A., Palombi, T., Alivernini, F., Lucidi, F., & Merluzzi, T. V. (2024) · Annals of Behavioral Medicine · doi:10.1093/abm/kaae025 · Cited by 15 · see citing works
Chronic stimulation desensitizes β2‐adrenergic receptor responses in natural killer cells
Jürgens, M., Claus, M., Wingert, S., Niemann, J. A., Picard, L. K., Hennes, E., Haasler, I., Hellwig, B., Overbeck, N., Reinders, J., et al. (2024) · European Journal of Immunology · doi:10.1002/eji.202451299 · Cited by 17 · see citing works
“In contrast to the effects of acute stress, chronic stress has negative effects on the immune system and can increase the risk of diseases, infections, and cancer [11, 64–66].”
Heo, J., Chun, M., Oh, Y., Noh, O. K., & Kim, L. (2017) · Psycho-Oncology · doi:10.1002/pon.4628 · Cited by 15 · see citing works
“The previous studies confirmed that emotional intervention was related to prognosis in ovarian cancer.(20) Also, ovarian cancer survivors receiving social support had lower tumor norepinephrine about tumor progression.”
ResultQuality of Life and Adverse Events: Prognostic Relationships in Long-Term Ovarian Cancer Survival
Wenzel, L. B., Osann, K., McKinney, C. O., Cella, D. F., Fulci, G., Scroggins, M. J., Lankes, H. A., Wang, V., Nephew, K. P., Maxwell, G. L., et al. (2021) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/djab034 · Cited by 15 · see citing works
“cluding the importance of high social attachment (38), with strong implications for future directions.”
BackgroundPsychosocial risk and management of physical diseases
Schneiderman, N., McIntosh, R. C., & Antoni, M. H. (2019) · Journal of Behavioral Medicine · doi:10.1007/s10865-018-00007-y · Cited by 15 · see citing works
Disparities in Psychosocial Distress Screening and Management of Lung and Ovarian Cancer Survivors
Rohan, E. A., Gallaway, M., Huang, G. C., Ng, D., Boehm, J. E., Samarasinha, R., & Stachon, K. (2022) · JCO Oncology Practice · doi:10.1200/op.22.00078 · Cited by 12 · see citing works
“are components of quality cancer care,(18-20) and psychosocial support has been associated with longer survival.(21)”
BackgroundMultilevel Stressors and Systemic and Tumor Immunity in Black and White Women With Breast Cancer
Harris, A. R., Pichardo, C. M., Franklin, J., Liu, H., Wooten, W., Panigrahi, G., Lawrence, W. R., Pichardo, M. S., Jenkins, B. D., Dorsey, T. H., et al. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.59754 · Cited by 14 · see citing works
Slavich, G. M., & Toussaint, L. L. (2013) · Stress and Health · doi:10.1002/smi.2523 · Cited by 12 · see citing works
“…© 2013 John Wiley & Sons, Ltd. Stress has also been implicated in accelerated biological aging and early mortality (Bennett, Fagundes, & Kiecolt-Glaser, 2013; Epel et al., 2004; Lutgendorf et al., 2012; Nielsen, Kristensen, Schnohr, & Grønbaek, 2008; O’Donovan, Slavich, Epel, & Neylan, 2013).”
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“, 2016); another stressed that emotional social support can offer beneficial effects on long-term survival outcomes in ovarian cancer patients (Lutgendorf et al., 2012).”
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Social support and ovarian cancer incidence – A Swedish prospective population-based study
Idahl, A., Hermansson, A., & Lalos, A. (2018) · Gynecologic Oncology · doi:10.1016/j.ygyno.2018.03.042 · Cited by 11 · see citing works
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Intergenerational resource sharing and mortality in a global perspective
Vogt, T. C., Kluge, F. A., & Lee, R. D. (2020) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1920978117 · Cited by 10 · see citing works
Social Support and Recovery from Disease and Medical Procedures
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- Authors
- Lutgendorf, S. K., De Geest, K., Bender, D., Ahmed, A., Goodheart, M. J., Dahmoush, L., Zimmerman, M. B., Penedo, F. J., Lucci, J. A., Ganjei-Azar, P., Thaker, P. H., Mendez, L., Lubaroff, D. M., Slavich, G. M., Cole, S. W., & Sood, A. K.
- Affiliations
- University of Iowa (US)
- Susan K. Lutgendorf, Koen De Geest, David Bender, Amina Ahmed, Michael J. Goodheart, Laila Dahmoush, M. Bridget Zimmerman, and David M. Lubaroff, University of Iowa; Susan K. Lutgendorf and David M. Lubaroff, Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Frank J. Penedo, Joseph A. Lucci III, and Parvin Ganjei-Azar, Sylvester Comprehensive Cancer Center, University of Miami, Coral Gables, FL; Premal H. Thaker, Washington University School of Medicine, St Louis, MO; Luis Mendez,...
- ORCID
- Venue
- Journal of Clinical Oncology
- Published
- 2012-08-10
- Volume
- 30
- Issue
- 23
- Pages
- 2885-2890
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- PMC
- PMC3410403
- OpenAlex
- W2154496739
- Cited by
- 177
- References
- 64
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 13 · 2023: 12 · 2022: 21 · 2021: 13 · 2020: 9 · 2019: 14 · 2018: 16 · 2017: 16 · 2016: 10 · 2015: 13 · 2014: 11 · 2013: 14 · 2012: 2
- FWCI
- 14.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Oncology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Iowa Research Online (The University of Iowa) (submittedVersion)
- Funders
- National Cancer Institute (CA 109298, R21CA088293, CA-104825, R01CA109298, CA140933, R01CA116778, R01CA104825, CA-116778, R01CA140933, P50CA083639, P30CA016672)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian cancer diagnosis and treatment
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Psychiatry and Mental health › Cancer, Stress, Anesthesia, and Immune Response
- Keywords
- ovarian cancer, social support, social attachment, instrumental support, survival, epithelial ovarian cancer, emotional support, adjuvant therapy
- MeSH terms
- Carcinoma, Ovarian Epithelial, Aged, Female, Humans, Middle Aged, Neoplasms, Glandular and Epithelial, Ovarian Neoplasms, Prospective Studies, Social Support, Proportional Hazards Models, Outcome Assessment, Health Care
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