Increased emotional distress in daughters of breast cancer patients is associated with decreased natural cytotoxic activity, elevated levels of stress hormones and decreased secretion of Th1 cytokines

Abstract

DBCP who are aware of their increased risk of developing breast cancer may suffer from high emotional distress. Chronic stress may interfere with NCA and low NCA is associated with increased cancer risk. We studied 80 DBCP and 47 age-and education-matched healthy females (controls). Heparinized venous blood (30 ml) was drawn from all subjects between 8 and 9 A.M., and each participant answered a set of psychologic questionnaires. In addition, the firstmorning urine sample was collected. DBCP scored significantly higher in emotional distress compared to controls. Levels of stress hormones in DBCP were higher and in vitro secretion of IL-2, IL-12 and IFN-␥ lower compared to controls. NCA against NK-resistant (MCF-7, COLO-205, U937) and NK-sensitive (K562) cell lines was significantly lower in DBCP and much less augmented by in vitro preincubation with IL-2 or IL-12 compared to controls. NCA and in vitro Th1 cytokine secretion were inversely correlated with the degree of emotional distress and the level of stress hormones in blood or urine. High emotional distress and elevated levels of stress hormones are associated with impaired immune surveillance functions in DBCP. This may contribute to the increased risk of DBCP to develop breast cancer. An interventional trial to enhance coping and reduce stress levels may help to decrease the risk for breast cancer onset in DBCP. © 2002 Wiley-Liss, Inc. Key words: chronic stress; daughters of breast cancer patients; natural cytotoxic activity; Th1 cytokines; stress hormonesThe critical question in immunosurveillance against cancer, which has so far remained unanswered, is whether differences between individuals with regard to immunologic host-defense mechanisms can predict the future development of cancer. Various in vivo studies in humans and mice have shown the significant role of different natural cytotoxic lymphocyte populations in preventing the development of cancer or its metastases. 1-4 However, only a few studies have investigated NCA of peripheral blood lymphocytes among healthy individuals in a general population or those at increased risk of developing cancer. 5-7 NCA has also been demonstrated to be an independent prognostic marker in patients with cancer. 8,9 Imai et al. 10 showed that selected lifestyle factors, such as maintaining body weight, not smoking, increasing intake of green vegetables and moderate alcohol consumption, may have an effect on natural cytotoxicity and that NCA can be increased by altering several lifestyle factors. Other studies have shown that restricted lifestyle changes, such as increasing exercise, losing weight and reducing fat and alcohol intake, are associated with a significant reduction in breast cancer risk (reviewed by Chlebowski 11 ).Whether emotional distress is associated with the onset of cancer in general and of breast cancer in particular has long been debated. Some studies have suggested that the overall prevalence of breast cancer is increased in women who have experienced stressful life events. 12,13 In contrast, the...

Psychosocial Adjustment in School-age Girls With a Family History of Breast Cancer

“…32 Furthermore, some data suggest that the chronic stress of growing up in a family at risk for breast cancer could have a negative impact on immunologic host responses that might prevent cancer. 27,33 Equally important, psychosocial distress can be associated with greater risk behaviors (eg, tobacco, alcohol use). Health and risk behaviors in preadolescence relate to the adoption and maintenance of health and risk behaviors throughout life, which is of particular importance for individuals at increased risk for cancer.…”

Maximizing Wellness in Successful Aging and Cancer Coping: The Importance of Family Communication from a Socioemotional Selectivity Theoretical Perspective

“…They face physical challenges including complications in sexual functioning and body image (Fobair, Stewart, Chang, D'Onfronio, Banks, & Bloom, 2005) and must learn to manage intensely complex psychological changes, like increased anger, loss of control, feelings of helplessness, increased anxiety, struggles with self-esteem and identity, and feelings of betrayal (see Spira & Kenemore, 2000, for a review). Some women experience symptoms of posttraumatic stress disorder (PTSD) (feelings of threatened death, physical integrity, or injury) (Cohen, Klein, Kuten, Fried, Zinder, & Pollack, 2002; Cohen & Pollack, 2005), changes that can manifest physiologically through increased levels of stress hormones and decreased immune functioning (Cohen & Pollack, 2005). All of these outcomes may be short-term health effects or manifest for an extended period of time leading to long-term health challenges (as is seen with PTSD outcomes).…”

The Integration of Emotional, Physiologic, and Communication Responses to Medical Oncology Surveillance Appointments During Breast Cancer Survivorship

“…Previous research links stressful events to altered immunity in both animal models 17 and cardiac patients 18 . Other research indicates that emotional stress is associated with decreases in NK activity and Th1 cytokines IL-2 and IFN-γ among daughters of women with breast cancer 19 . Decreased IL-2 production and NK production have also been associated with increased norepinephrine and cortisol implying neuroendocrine mediation (Cohen et al, 2002).…”