PURPOSE:Psychological interventions are efficacious in reducing emotional distress for cancer patients. However, it is not clear whether psychological improvements are, in turn, related to improved health. A clinical trial tests whether a psychological intervention for cancer patients can do so, and also tests two routes to achieve better health: (a) reducing patients' Emotional Distress, and/or (b) enhancing their functional immunity. METHODS: Post-surgery, 227 breast cancer patients were randomized to intervention or assessment only Study Arms. Conducted in small groups, intervention sessions were offered weekly for 4 months and followed by monthly sessions for 8 months. Measures included psychological (distress), biological (immune), and health outcomes (performance status and evaluations of patient's symptomatology, including toxicity from cancer treatment, lab values) collected at baseline, 4 months, and 12 months. RESULTS: A path model revealed that intervention participation directly improved health (p<.05) at 12 months. These effects remained when statistically controlling for baseline levels of distress, immunity, and health as well as sociodemographic, disease, and cancer treatment variables. Regarding the mechanisms for achieving better health, support was found for an indirect effect of distress reduction. That is, by specifically lowering intervention patients' distress at 4 months, their health was improved at 12 months (p<.05). Although the intervention simultaneously improved patients' T-cell blastogenesis in response to phytohemagglutinin (PHA), the latter increases were unrelated to improved health. CONCLUSION: A convergence of biobehavioral effects and health improvements were observed. Behavioral change, rather than immunity change, was influential in achieving lower levels of symptomatology and higher functional status. Distress reduction is highlighted as an important mechanism by which health can be improved.
RCT Entities:
PURPOSE: Psychological interventions are efficacious in reducing emotional distress for cancerpatients. However, it is not clear whether psychological improvements are, in turn, related to improved health. A clinical trial tests whether a psychological intervention for cancerpatients can do so, and also tests two routes to achieve better health: (a) reducing patients' Emotional Distress, and/or (b) enhancing their functional immunity. METHODS: Post-surgery, 227 breast cancerpatients were randomized to intervention or assessment only Study Arms. Conducted in small groups, intervention sessions were offered weekly for 4 months and followed by monthly sessions for 8 months. Measures included psychological (distress), biological (immune), and health outcomes (performance status and evaluations of patient's symptomatology, including toxicity from cancer treatment, lab values) collected at baseline, 4 months, and 12 months. RESULTS: A path model revealed that intervention participation directly improved health (p<.05) at 12 months. These effects remained when statistically controlling for baseline levels of distress, immunity, and health as well as sociodemographic, disease, and cancer treatment variables. Regarding the mechanisms for achieving better health, support was found for an indirect effect of distress reduction. That is, by specifically lowering intervention patients' distress at 4 months, their health was improved at 12 months (p<.05). Although the intervention simultaneously improved patients' T-cell blastogenesis in response to phytohemagglutinin (PHA), the latter increases were unrelated to improved health. CONCLUSION: A convergence of biobehavioral effects and health improvements were observed. Behavioral change, rather than immunity change, was influential in achieving lower levels of symptomatology and higher functional status. Distress reduction is highlighted as an important mechanism by which health can be improved.
Authors: Annette L Stanton; Sharon Danoff-Burg; Lisa A Sworowski; Charlotte A Collins; Ann D Branstetter; Alicia Rodriguez-Hanley; Sarah B Kirk; Jennifer L Austenfeld Journal: J Clin Oncol Date: 2002-10-15 Impact factor: 44.544
Authors: Barbara L Andersen; William B Farrar; Deanna M Golden-Kreutz; Ronald Glaser; Charles F Emery; Timothy R Crespin; Charles L Shapiro; William E Carson Journal: J Clin Oncol Date: 2004-09-01 Impact factor: 44.544
Authors: Susan K Lutgendorf; Erica L Johnsen; Brian Cooper; Barrie Anderson; Joel I Sorosky; Richard E Buller; Anil K Sood Journal: Cancer Date: 2002-08-15 Impact factor: 6.860
Authors: Patricia A Ganz; Lorna Kwan; Annette L Stanton; Janice L Krupnick; Julia H Rowland; Beth E Meyerowitz; Julienne E Bower; Thomas R Belin Journal: J Natl Cancer Inst Date: 2004-03-03 Impact factor: 13.506
Authors: Susan M Allen; Ann C Shah; Arthur M Nezu; Christine Maguth Nezu; Desirée Ciambrone; Joseph Hogan; Vincent Mor Journal: Cancer Date: 2002-06-15 Impact factor: 6.860
Authors: Barbara L Andersen; Lisa M Thornton; Charles L Shapiro; William B Farrar; Bethany L Mundy; Hae-Chung Yang; William E Carson Journal: Clin Cancer Res Date: 2010-06-08 Impact factor: 12.531
Authors: Brittany M Brothers; Kristen M Carpenter; Rebecca A Shelby; Lisa M Thornton; Georita M Frierson; Kyle L Patterson; Barbara L Andersen Journal: Transl Behav Med Date: 2015-03 Impact factor: 3.046
Authors: Lisa M Gudenkauf; Michael H Antoni; Jamie M Stagl; Suzanne C Lechner; Devika R Jutagir; Laura C Bouchard; Bonnie B Blomberg; Stefan Glück; Robert P Derhagopian; Gladys L Giron; Eli Avisar; Manuel A Torres-Salichs; Charles S Carver Journal: J Consult Clin Psychol Date: 2015-05-04
Authors: Anne Moyer; Matthew Goldenberg; Matthew A Hall; Sarah K Knapp-Oliver; Stephanie J Sohl; Elizabeth A Sarma; Stefan Schneider Journal: Behav Med Date: 2012 Impact factor: 3.104
Authors: Andrew H Miller; Sonia Ancoli-Israel; Julienne E Bower; Lucile Capuron; Michael R Irwin Journal: J Clin Oncol Date: 2008-02-20 Impact factor: 44.544