Abstract
Breast cancer (BCa) patients revealing poorer psychological adaptation after surgery show greater inflammation and have poorer long-term outcomes. Our 10-wk group cognitive behavioral stress management (CBSM) intervention showed concomitant 12-month improvements in adaptation and downregulated leukocyte pro-inflammatory and pro-metastatic and upregulated glucocorticoid (GC) regulatory and anti-viral gene expression vs psycho-education controls.
In a dismantling trial (N = 183) we compared 5-wk post-surgical interventions featuring one CBSM component—Cognitive Behavioral Therapy [CBT] or Relaxation Training [RT]—vs a 5-wk Health Education (HE) control for effects on adaptation and inflammatory signaling over 12 months of BCa treatment. Since bioinformatics analysis of the 10-wk CBSM trial inferred reduced NFκB signaling underlying CBSM effects on downstream leukocyte gene expression, we extracted nuclear protein from PBMCs to determine NFκB DNA binding by electromobility shift assay.
Women assigned to CBT or RT showed improved adaptation (affect and social disruption) and decreased NFκB binding over 12-months vs HE (p’s <.05). Greater adaptation at 12-months was associated with less NFκB-DNA binding. RT or CBT also showed reductions (vs HE) in ligands (s100A8/A9) for the Receptor for Advanced Glycation End Products (RAGE), which is implicated in NFκB activation and MAPK-mediated pro-metastatic processes (p < .05).
Providing post-surgical BCa patients with brief stress management can improve adaptation and immune cell signaling during primary treatment, and may improve long-term health outcomes.
