Grant Number:	1R01CA125455-01A2 Interpret this number
Primary Investigator:	Mathews, Herbert
Organization:	Loyola University Chicago
Project Title:	Mindfulness Based Stress Reduction for Psycho-Immune Dysregulation in Cancer
Fiscal Year:	2008

DESCRIPTION (provided by applicant): Breast cancer is the second leading cause of cancer death in American women, with over 39,000 women dying of breast cancer yearly. Breast cancer diagnosis and treatment cause psychosocial distress, disrupted social relationships, anxiety, poor sleep, uncertainty, and fear of cancer recurrence. This distress can extend beyond treatment and adversely affect health-related quality of life (HRQOL). Interventions that stem the tide of negative emotions and their physiological sequelae are needed. Psychoneuroimmunology (PNI) has established that psychosocial distress impairs immune function. We have shown that women diagnosed with breast cancer have significant psychosocial distress that is accompanied by dysregulated natural killer cell activity (NKCA) and cytokine production. These observations are especially important in that impairment of these forms of immune function is associated with increased tumor initiation, primary tumor growth and tumor metastasis. Metastatic disease is the primary cause of death from breast cancer. Mindfulness based stress reduction (MBSR) is a mind-body intervention that shows promise for management of the distress associated with cancer. We show that MBSR reduces neuroendocrine stress activation and improves immune function and quality of life of breast cancer patients during the vulnerable period of cancer diagnosis and treatment. Using a randomized controlled design, this study will evaluate the potential benefits of MBSR on psychosocial distress, neuroendocrine stress activation, immune function, and HRQOL. Women with early stage breast cancer will be randomized to an 8-week MBSR intervention or a control condition. Assessments of immune function (NKCA and cytokines), neuroendocrine activity (salivary cortisol and plasma catecholamines), psychosocial response, and HRQL will be obtained pre-, mid-, at completion, and post-MBSR. Hypotheses will test whether MBSR can improve the psychosocial response of women to breast cancer diagnosis and treatment, reduce neuroendocrine stress activation, restore immune function, and increase HRQOL. The relationship among main study variables will be explored by mediation model testing. These assessments will be achieved during the critical period of cancer diagnosis and treatment when restoration of immune function is most significant. Understanding the trajectory and the nature of the psycho-endocrine-immune response to a promising mind-body approach like MBSR, using a rigorous design in a well-defined cancer population, will significantly contribute to the science of PNI and to integrative cancer care. PUBLIC HEALTH RELEVANCE: Alternative or complementary approaches that enhance the quality of life of women with breast cancer have grown in popularity. Yet, there is a lack of empirical analysis of such approaches using rigorous scientific design. The proposed study will so evaluate one such approach, mindfulness based stress reduction, in a population of women with breast cancer and in comparison to a matched group of women without cancer.




Mindfulness Predicts Psycho-behavioral Improvement after Breast Cancer Diagnosis: Influence of Childhood Adversity.
Authors: Janusek L.W. , Tell D. , Mathews H.L. .
Source: Western Journal Of Nursing Research, 2021 03; 43(3), p. 239-249.
EPub date: 2020-06-07 00:00:00.0.
PMID: 32508281
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Mindfulness based stress reduction provides psychological benefit and restores immune function of women newly diagnosed with breast cancer: A randomized trial with active control.
Authors: Witek Janusek L. , Tell D. , Mathews H.L. .
Source: Brain, Behavior, And Immunity, 2019 08; 80, p. 358-373.
EPub date: 2019-04-03 00:00:00.0.
PMID: 30953776
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During stress, heart rate variability moderates the impact of childhood adversity in women with breast cancer.
Authors: Tell D. , Mathews H.L. , Burr R.L. , Witek Janusek L. .
Source: Stress (amsterdam, Netherlands), 2018 03; 21(2), p. 179-187.
EPub date: 2018-02-01 00:00:00.0.
PMID: 29385886
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Day-to-day Dynamics Of Associations Between Sleep, Napping, Fatigue, And The Cortisol Diurnal Rhythm In Women Diagnosed As Having Breast Cancer
Authors: Tell D. , Mathews H.L. , Janusek L.W. .
Source: Psychosomatic Medicine, 2014 Sep; 76(7), p. 519-28.
PMID: 25186656
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Childhood adversity increases vulnerability for behavioral symptoms and immune dysregulation in women with breast cancer.
Authors: Witek Janusek L. , Tell D. , Albuquerque K. , Mathews H.L. .
Source: Brain, Behavior, And Immunity, 2013 Mar; 30 Suppl, p. S149-62.
PMID: 22659062
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Epigenetics and psychoneuroimmunology: mechanisms and models.
Authors: Mathews H.L. , Janusek L.W. .
Source: Brain, Behavior, And Immunity, 2011 Jan; 25(1), p. 25-39.
PMID: 20832468
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Psychologic stress, reduced NK cell activity, and cytokine dysregulation in women experiencing diagnostic breast biopsy.
Authors: Witek-Janusek L. , Gabram S. , Mathews H.L. .
Source: Psychoneuroendocrinology, 2007 Jan; 32(1), p. 22-35.
PMID: 17092654
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