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A pilot randomized trial assessing the effect of a psychoeducational intervention on psychoneuroimmunological parameters among patients with non-metastatic breast cancer.
Psychosomatic Medicine 2018 November 28
OBJECTIVE: The aim of this study was to determine a potential benefit of the specific psycho-educational intervention "Learning to Live with Cancer" (LTLWC) for patients with operated non-metastatic breast cancer, with respect to psychological variables and endocrine and immune parameters.
METHODS: Fifty-two postmenopausal women with operated stage I - III breast cancer were randomized to either a breast cancer intervention group (BCIG, n=30) who immediately began participating in the LTLWC intervention program or to a breast cancer control group (BCCG, n=22).Matched healthy women were asked to participate as a non-cancer comparison group (NCCG, n=26). All participants were evaluated at three different time points (t1-t3) using a set of standardized questionnaires and blood samples were taken to analyze immune cell subsets and stress hormone levels.
RESULTS: A significant reduction in trait anxiety/STAI (State Trait Anxiety Inventory) score was observed in the BCIG (t1:median=35.0 (interquartile range:28.0-38.0) vs. t3=26.0(18.5-37.0), p=.0001) compared to the BCCG (t1 = 41.0 (32.75-49.0); t3 = 38.5 (30.75 - 46.5, p = .01524; p interaction = .001).In parallel, a significant rise of serotonin levels (t1:median=66.5 ng/ml (interquartile range:11.50-106.00) vs. t3=80.5 ng/ml(59.00-118.00), p=.00008) as well as a significant reduction of the elevated number of Treg cells at baseline (t1:median=4.45% (interquartile range:4.00-5.33) vs. t3=2.80% (2.68-3.13), p<.00001) were observed in the BCIG versus no change in the BCCG. A significant statistical association between reduced trait anxiety and decreased Treg cell number could be demonstrated in the BCIG (r=.62; p<.01).
CONCLUSIONS: The observed results of this study provide preliminary support for the efficacy of the LTLWC program in significantly improving psychoneuroimmunological parameters in patients with non-metastatic breast cancer.
METHODS: Fifty-two postmenopausal women with operated stage I - III breast cancer were randomized to either a breast cancer intervention group (BCIG, n=30) who immediately began participating in the LTLWC intervention program or to a breast cancer control group (BCCG, n=22).Matched healthy women were asked to participate as a non-cancer comparison group (NCCG, n=26). All participants were evaluated at three different time points (t1-t3) using a set of standardized questionnaires and blood samples were taken to analyze immune cell subsets and stress hormone levels.
RESULTS: A significant reduction in trait anxiety/STAI (State Trait Anxiety Inventory) score was observed in the BCIG (t1:median=35.0 (interquartile range:28.0-38.0) vs. t3=26.0(18.5-37.0), p=.0001) compared to the BCCG (t1 = 41.0 (32.75-49.0); t3 = 38.5 (30.75 - 46.5, p = .01524; p interaction = .001).In parallel, a significant rise of serotonin levels (t1:median=66.5 ng/ml (interquartile range:11.50-106.00) vs. t3=80.5 ng/ml(59.00-118.00), p=.00008) as well as a significant reduction of the elevated number of Treg cells at baseline (t1:median=4.45% (interquartile range:4.00-5.33) vs. t3=2.80% (2.68-3.13), p<.00001) were observed in the BCIG versus no change in the BCCG. A significant statistical association between reduced trait anxiety and decreased Treg cell number could be demonstrated in the BCIG (r=.62; p<.01).
CONCLUSIONS: The observed results of this study provide preliminary support for the efficacy of the LTLWC program in significantly improving psychoneuroimmunological parameters in patients with non-metastatic breast cancer.
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