Psychosocial intervention effects on adaptation, disease course and biobehavioral processes in cancer

Abstract

A diagnosis of cancer and subsequent treatments place demands on psychological adaptation. Behavioral research suggests the importance of cognitive, behavioral, and social factors in facilitating adaptation during active treatment and throughout cancer survivorship, which forms the rationale for the use of many psychosocial interventions in cancer patients. This cancer experience may also affect physiological adaptation systems (e.g., neuroendocrine) in parallel with psychological adaptation changes (negative affect). Changes in adaptation may alter tumor growth-promoting processes (increased angiogenesis, migration and invasion, and inflammation) and tumor defense processes (decreased cellular immunity) relevant for cancer progression and the quality of life of cancer patients. Some evidence suggests that psychosocial intervention can improve psychological and physiological adaptation indicators in cancer patients. However, less is known about whether these interventions can influence tumor activity and tumor growth-promoting processes and whether changes in these processes could explain the psychosocial intervention effects on recurrence and survival documented to date. Documenting that psychosocial interventions can modulate molecular activities (e.g., transcriptional indicators of cell signaling) that govern tumor promoting and tumor defense processes on the one hand, and clinical disease course on the other is a key challenge for biobehavioral oncology research. This mini-review will summarize current knowledge on psychological and physiological adaptation processes affected throughout the stress of the cancer experience, and the effects of psychosocial interventions on psychological adaptation, cancer disease progression, and changes in stress-related biobehavioral processes that may mediate intervention effects on clinical cancer outcomes. Very recent intervention work in breast cancer will be used to illuminate emerging trends in molecular probes of interest in the hope of highlighting future paths that could move the field of biobehavioral oncology intervention research forward.

Mindfulness‐based cancer recovery and supportive‐expressive therapy maintain telomere length relative to controls in distressed breast cancer survivors

“…15,16 Although stress plays a role in the etiology and progression of many diseases, [17][18][19] the role of stress in cancer remains suggestive. 20,21 Nonetheless, several biobehavioral pathways between psychosocial stress and mechanisms of cancer development have been indentified. 20,22 Telomere biology represents another provocative potential pathway that may link psychosocial influences with cancer progression.…”

“…20,21 Nonetheless, several biobehavioral pathways between psychosocial stress and mechanisms of cancer development have been indentified. 20,22 Telomere biology represents another provocative potential pathway that may link psychosocial influences with cancer progression. 23 One report of associations between decreases in distress levels and increased TL over a 4-month period in survivors of cervical cancer is to our knowledge the only current evidence of associations between TL and stress in individuals with cancer.…”

Helplessness/hopelessness, minimization and optimism predict survival in women with invasive ovarian cancer: a role for targeted support during initial treatment decision-making?

“…al. have propose an integrative bio-behavioral stress-response model, noting that chronic stress, negative affect and social adversity have been associated with increased sympathetic nervous system signaling, hypothalamic pituitary adrenal axis dysregulation, inflammation and decreased cellular immunity, which could interact with the tumor microenvironment to promote factors favoring tumor growth [5,[9][10]. It is also possible that some psychosocial factors may impact on survival differently, depending on the disease site and stage, as we previously reported among patients with early and metastatic breast cancer and melanoma [11][12][13][14].…”

Social instability and immunity in rhesus monkeys: the role of the sympathetic nervous system

“…Our hypothesis was that cortisol would not be affected, but the catecholamines would be. In addition, after animals had been shifted from Stable to Unstable conditions for five weeks, we shifted them back to Stable conditions in order to test the hypothesis that our measures would return to pre-stress levels; there is some evidence in the human literature that psychological interventions can impact disease-relevant measures of immunity [24], but to the best of our knowledge no such studies have examined measures of SNS activity.…”