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Grant Details

Grant Number: 5R01CA176809-03 Interpret this number
Primary Investigator: Steel, Jennifer
Organization: University Of Pittsburgh At Pittsburgh
Project Title: Biobehavioral Pathways Linking Stress and Cancer Progression
Fiscal Year: 2014


DESCRIPTION (provided by applicant): In 2010, over 11.5 million people were living with cancer in the United States and over 500,000 new cases are expected to be diagnosed each year. The life threatening and unpredictable course of cancer makes it a particularly stressful lif experience. Stress may be defined as when the demands being placed on an individual are perceived as threatening or harmful and exceed the resources available to manage the stressor. Decades of research have shown that stress is associated with maladaptive health behaviors (e.g., high fat diet) as well as increased risk of morbidity and mortality. The goal of this prospective study is to examine the mechanistic pathways linking chronic stress and engagement in maladaptive health behaviors with disease progression in people diagnosed with hepatobiliary carcinoma. The proposed study will begin to elucidate the biobehavioral pathways linking stress and health behaviors with disease progression in the context of cancer. The aims and hypotheses of this study are: (1) to investigate predictors of the psychological and physiological stress response to a diagnosis or recurrence of hepatobilary carcinoma. We expect that people who report a past history of early adverse events (e.g., death of a loved one, abuse) will report higher levels of perceived stress and elevations in biomarkers of inflammation. Early adverse events are expected to be associated with an earlier age of onset of these maladaptive health behaviors (e.g., alcohol use) and contributed to the risk factors associated with the development of cancer (e.g., cirrhosis); (2) to examine the dynamic link between stress and health behaviors over time in people diagnosed with hepatobiliary carcinoma. We expect high levels of chronic stress to be associated with (a) attempts to change maladaptive health behaviors or adopt adaptive health behaviors, or (b) attempts to decrease physiological arousal by continued use or re-initiation of maladaptive health behaviors. We expect that a positive illness perception will mediate the link between perceived stress and health behaviors and that problem focused coping and social support will moderate this relationship. Engaging in maladaptive behaviors to reduce stress will be mediated by negative illness perceptions and moderated by emotion focused coping and lack of social support; (3) to explore the links between stress, health behaviors, and biomarkers of inflammation on disease progression. We expect that patients with a combination of chronic stress and/or engagement in maladaptive health behaviors will have abnormal levels of biomarkers of inflammation and more rapid tumor growth and development of intra- and extra-hepatic metastases when compared to patients with lower levels of perceived stress or adaptive health behaviors. The proposed study is responsive to the RFA which request studies that will "examine mediating and moderating factors such as individual demographic (age, gender/sex, ethnicity) and psychological (vulnerabilities, resilience) differences, risk factors, early exposure to stress". The findings of this study are expected to lead to potential psychological and behavioral targets for interventions to improve quality of life and reduce mortality in people diagnosed with cancer.


Adverse childhood experiences (ACEs), cell-mediated immunity, and survival in the context of cancer.
Authors: Steel J.L. , Antoni M. , Pathak R. , Butterfield L.H. , Vodovotz Y. , Savkova A. , Wallis M. , Wang Y. , Jing H. , Grammer E. , et al. .
Source: Brain, behavior, and immunity, 2020 08; 88, p. 566-572.
EPub date: 2020-04-24.
PMID: 32339603
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Health-Related Quality of Life Is Decreased After Necrotizing Soft-Tissue Infections.
Authors: Suijker J. , de Vries A. , de Jong V.M. , Schepers T. , Ponsen K.J. , Halm J.A. .
Source: The Journal of surgical research, 2020 01; 245, p. 516-522.
EPub date: 2019-08-23.
PMID: 31450039
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Health-Related Quality of Life as a Prognostic Factor in Patients After Resection of Hepatic Malignancies.
Authors: Tohme S. , Sanin G.D. , Patel V. , Bress K. , Ahmed N. , Krane A. , Tsung A. , Steel J.L. .
Source: The Journal of surgical research, 2020 01; 245, p. 257-264.
EPub date: 2019-08-14.
PMID: 31421371
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Illness perceptions and perceived stress in patients with advanced gastrointestinal cancer.
Authors: Miceli J. , Geller D. , Tsung A. , Hecht C.L. , Wang Y. , Pathak R. , Cheng H. , Marsh W. , Antoni M. , Penedo F. , et al. .
Source: Psycho-oncology, 2019 07; 28(7), p. 1513-1519.
EPub date: 2019-06-04.
PMID: 31090125
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Substance Use, Depression, and Illness Perception Among Cancer Patients.
Authors: Kosciusko R. , Geller D. , Kucinski B. , Shadel W. , Vanegas Y. , Tsung A. , Marsh W. , Steel J. .
Source: American journal of health behavior, 2019-03-01; 43(2), p. 287-299.
PMID: 30808469
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Comparison of Fatigue, Pain, and Depression in Patients With Advanced Kidney Disease and Cancer-Symptom Burden and Clusters.
Authors: Jhamb M. , Abdel-Kader K. , Yabes J. , Wang Y. , Weisbord S.D. , Unruh M. , Steel J.L. .
Source: Journal of pain and symptom management, 2019 03; 57(3), p. 566-575.e3.
EPub date: 2018-12-13.
PMID: 30552961
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Putting the life in lifestyle: Lifestyle choices after a diagnosis of cancer predicts overall survival.
Authors: Krane A. , Terhorst L. , Bovbjerg D.H. , Scheier M.F. , Kucinski B. , Geller D.A. , Marsh W. , Tsung A. , Steel J.L. .
Source: Cancer, 2018 08; 124(16), p. 3417-3426.
EPub date: 2018-07-05.
PMID: 29975412
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Quality of life as a prognostic indicator of survival: A pooled analysis of individual patient data from canadian cancer trials group clinical trials.
Authors: Ediebah D.E. , Quinten C. , Coens C. , Ringash J. , Dancey J. , Zikos E. , Gotay C. , Brundage M. , Tu D. , Flechtner H.H. , et al. .
Source: Cancer, 2018 08; 124(16), p. 3409-3416.
EPub date: 2018-06-15.
PMID: 29905936
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Prospective Analyses of Cytokine Mediation of Sleep and Survival in the Context of Advanced Cancer.
Authors: Steel J.L. , Terhorst L. , Collins K.P. , Geller D.A. , Vodovotz Y. , Kim J. , Krane A. , Antoni M. , Marsh J.W. , Burke L.E. , et al. .
Source: Psychosomatic medicine, 2018 06; 80(5), p. 483-491.
PMID: 29621045
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Sleep duration is associated with survival in advanced cancer patients.
Authors: Collins K.P. , Geller D.A. , Antoni M. , Donnell D.M. , Tsung A. , Marsh J.W. , Burke L. , Penedo F. , Terhorst L. , Kamarck T.W. , et al. .
Source: Sleep medicine, 2017 Apr; 32, p. 208-212.
EPub date: 2017-01-20.
PMID: 28366336
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The Psychosocial and Independent Living Donor Advocate Evaluation and Post-surgery Care of Living Donors.
Authors: Rudow D.L. , Swartz K. , Phillips C. , Hollenberger J. , Smith T. , Steel J.L. .
Source: Journal of clinical psychology in medical settings, 2015 Sep; 22(2-3), p. 136-49.
PMID: 26293351
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