SUMMARY Aims: In this paper, we examine the long-term consequences of a breast cancer diagnosis on hypothalamic–pituitary–adrenal axis functioning. Methods: This study provides a comprehensive analysis of the diurnal and reactive cortisol profiles of breast cancer survivors considered ‘disease-free’ compared with women with no history of breast cancer. Results: The results indicate similar diurnal patterns in both groups; however, significant differences in stress reactivity were noted, with breast cancer survivors displaying a relatively flat profile following the acute stress induction. Subjective levels of psychological stress were similar in both groups, suggesting incongruence between perceived stress and the physiological stress response of breast cancer survivors. Conclusion: The patterns suggest a progression towards more typical cortisol reactivity with longer time since diagnosis and may reflect some recovery of hypothalamic–pituitary–adrenal axis functioning as time passes.
The two main components of the stress system are the hypothalamic-pituitary-adrenal (HPA) and sympathetic-adrenal-medullary (SAM) axes. While cortisol has been commonly used as a biomarker of HPA functioning, much less attention has been paid to the role of the SAM in this context. Studies have shown that long-term breast cancer survivors display abnormal reactive cortisol patterns, suggesting a dysregulation of their HPA axis. To fully understand the integrity of the stress response in this population, this paper explored the diurnal and acute alpha-amylase profiles of 22 breast cancer survivors and 26 women with no history of cancer. Results revealed that breast cancer survivors displayed identical but elevated patterns of alpha-amylase concentrations in both diurnal and acute profiles relative to that of healthy women, F (1, 39) = 17.95, p < 0.001 and F (1, 37) = 7.29, p = 0.010, respectively. The average area under the curve for the diurnal and reactive profiles was 631.54 ± 66.94 SEM and 1238.78 ± 111.84 SEM, respectively. This is in sharp contrast to their cortisol results, which showed normal diurnal and blunted acute patterns. The complexity of the stress system necessitates further investigation to understand the synergistic relationship of the HPA and SAM axes.
Le but de cette étude était d'évaluer si les couples dont la femme a le cancer du sein réagissent à la thérapie de couple axée sur l'émotion (EFT) de la même façon que les couples en bonne santé, c'est-à-dire avec un niveau croissant d'interactions positives ainsi qu'avec un niveau croissant d'experiencing (capacité à prendre conscience de ses émotions et à les verbaliser). Les enregistrements des séances de thérapie de deux couples dont la femme présente un cancer du sein ont été évalués. Les résultats suggèrent que le processus thérapeutique des couples dont la femme a le cancer du sein est semblable à celui des couples en bonne santé. Les implications cliniques des résultats sont discutées.Mots clés : Thérapie de couple axée sur l'émotion -Cancer du sein -Thérapie de couple Abstract: The purpose of this study was to determine whether couples with female partners who suffer from breast cancer would respond to emotionally focused therapy (EFT) in the same way as couples with healthy partners (i.e. increasing levels of emotional experiencing and affiliative interactions). The therapeutic sessions of two couples, each with a female partner suffering from breast cancer, were evaluated and coded. The results suggest that the therapeutic process experienced by couples with a female partner suffering from breast cancer is similar to that experienced by couples with partners in normal physical health. We discuss the clinical implications of these results.
IntroductionOne way to examine the extent to which the stress associated with a breast cancer experience (BC) impacts stress-related physiological mechanisms is to study the secretion patterns of associated biomarkers. Unlike cortisol and α-amylase (sAA), biomarkers of immune functioning such as secretory immunoglobulin A (SIgA) have rarely been examined in BC survivors.Aim of the studyThis study had two principal aims: the first was to evaluate the basal secretion profiles of SIgA as well as its response to an acute stressor as a marker of immune health in BC survivors and women with no history of BC, and the second was to determine how SIgA stress-related patterns compare to published cortisol and sAA patterns in the same women.ResultsOverall, the findings indicate that BC survivors exhibit a blunted cortisol reaction to an acute stressor, a generally elevated diurnal sAA concentration pattern, and normal SIgA profiles, compared to women with no history of cancer. This study serves as a foundation for future research to elucidate the relationships between BC experience variables, stress biomarkers, and health outcomes in BC survivors.
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