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Grant Details

Grant Number: 5R01CA090966-05 Interpret this number
Primary Investigator: Cohen, Lorenzo
Organization: University Of Tx Md Anderson Can Ctr
Project Title: Biobehavioral Effects of Emotional Expression in Cancer
Fiscal Year: 2006


Models of cognitive processing suggest that once a traumatic event is appropriately understood and integrated the stress associated with the event will diminish. Thoughts and feelings surrounding a traumatic experience are often disorganized, yet when disclosed verbally or through writing, they can assume the form of an organized, coherent narrative resulting in improved health outcomes. This is illustrated by recent findings that indicated that a brief written emotional expression exercise was associated with improved physical health, psychological well-being, physiological functioning, and general functioning. This writing exercise was also associated with beneficial changes in immune function. The brief writing intervention is hypothesized to increase cognitive processing and foster adaptation to traumatic events. To date, however, most research examining this intervention has been conducted in healthy populations. The diagnosis and treatment of cancer are traumatic experiences associated with distress and the fear of cancer recurrence, progression, and death. The impact of stress on the immune system may be particularly detrimental to patients with renal cell cancer, as this cancer is immunogenic, meaning that the immune system regulates progression of the disease. Because emotional expression writing interventions have been shown to facilitate adaptation, reduce stress, improve psychological adjustment and QOL, and positively impact immune function, this type of intervention may be beneficial in patients with renal cancer. Pilot data from our laboratory suggest that it is feasible to conduct the emotional expression writing intervention in patients with renal cancer. Results from this study also provide initial evidence that the intervention increases cognitive processing and improves psychological well- being. The proposed study will assess the benefits of this written emotional expression exercise in patients with renal cell carcinoma. Patients in this study will be randomly assigned either to an emotional expression writing group or to a neutral writing group. This research will also evaluate the extent to which psychosocial factors mediate or moderate the effects of the intervention program and predict recovery and adjustment. The effects of the intervention should be evident throughout recovery and across indices of quality of life, mental health, subjective symptoms of stress, and immune function.


Religious Coping in Cancer: A Quantitative Analysis of Expressive Writing Samples From Patients With Renal Cell Carcinoma.
Authors: Narayanan S. , Milbury K. , Wagner R. , Cohen L. .
Source: Journal of pain and symptom management, 2020 Oct; 60(4), p. 737-745.e3.
EPub date: 2020-05-06.
PMID: 32387140
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Interconnection: A qualitative analysis of adjusting to living with renal cell carcinoma.
Authors: Leal I. , Milbury K. , Engebretson J. , Matin S. , Jonasch E. , Tannir N. , Wood C.G. , Cohen L. .
Source: Palliative & supportive care, 2018 Apr; 16(2), p. 146-154.
EPub date: 2017-03-06.
PMID: 28262086
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A Bayesian semiparametric latent variable approach to causal mediation.
Authors: Kim C. , Daniels M. , Li Y. , Milbury K. , Cohen L. .
Source: Statistics in medicine, 2018-03-30; 37(7), p. 1149-1161.
EPub date: 2017-12-18.
PMID: 29250817
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Examination of moderators of expressive writing in patients with renal cell carcinoma: the role of depression and social support.
Authors: Milbury K. , Lopez G. , Spelman A. , Wood C. , Matin S.F. , Tannir N.M. , Jonasch E. , Pisters L. , Wei Q. , Cohen L. .
Source: Psycho-oncology, 2017 Sep; 26(9), p. 1361-1368.
EPub date: 2016-05-03.
PMID: 27145447
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Adrenergic-mediated increases in INHBA drive CAF phenotype and collagens.
Authors: Nagaraja A.S. , Dood R.L. , Armaiz-Pena G. , Kang Y. , Wu S.Y. , Allen J.K. , Jennings N.B. , Mangala L.S. , Pradeep S. , Lyons Y. , et al. .
Source: JCI insight, 2017-08-17; 2(16), .
EPub date: 2017-08-17.
PMID: 28814667
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Posttraumatic stress and depressive symptoms in renal cell carcinoma: association with quality of life and utility of single-item distress screening.
Authors: Thekdi S.M. , Milbury K. , Spelman A. , Wei Q. , Wood C. , Matin S.F. , Tannir N. , Jonasch E. , Pisters L. , Cohen L. .
Source: Psycho-oncology, 2015 Nov; 24(11), p. 1477-84.
EPub date: 2015-02-17.
PMID: 25690556
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Randomized controlled trial of expressive writing for patients with renal cell carcinoma.
Authors: Milbury K. , Spelman A. , Wood C. , Matin S.F. , Tannir N. , Jonasch E. , Pisters L. , Wei Q. , Cohen L. .
Source: Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2014-03-01; 32(7), p. 663-70.
EPub date: 2014-01-27.
PMID: 24470003
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Screening for depressed mood in patients with cancer using the MD Anderson Symptom Inventory: investigation of a practical approach for the oncologist.
Authors: Jones D. , Vichaya E.G. , Cleeland C.S. , Cohen L. , Thekdi S.M. , Wang X.S. , Fisch M.J. .
Source: Journal of oncology practice, 2014 Mar; 10(2), p. e95-102.
EPub date: 2013-11-26.
PMID: 24281151
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