23 Mar Stress Management Reduces Depression In Breast Cancer
MedicalResearch.com Interview with:
Michael H. Antoni, Ph.D.
Professor of Psychology and Psychiatry and Behavioral Sciences
Director, Center for Psycho-oncology Research
Program co-Leader, Cancer Prevention Control and Survivorship
Sylvester Cancer Center Sylvester Professor, Director Miami CTSI Pilot and Translational Studies Component University of Miami
Medical Research: What is the background for this study? What are the main findings?
Dr. Antoni: We have been conducting stress management intervention trials with breast cancer patients for the past two decades. We have shown that the form of stress management we developed, a 10-week cognitive behavioral stress management (CBSM) intervention, combining relaxation techniques, cognitive behavioral therapy techniques and coping and interpersonal skills training (assertiveness and anger management) delivered in a supportive group, can improve how women adapt during breast cancer treatment and up to one year later. These improvements in psychological status (less depressive symptoms, less negative mood and more positive mood) are associated with reductions in circulating serum cortisol levels, improved immune function and decreased inflammatory signaling over the first year of treatment. Since depressive symptoms are prevalent during cancer treatment our prior work showing that cognitive behavioral stress management reduces depressive symptoms over the 1st yr of treatment is significant . Since persisting depressive symptoms into survivorship are also common these new findings that women receiving cognitive behavioral stress management during primary treatment show beneficial effects out to 15 yrs suggests a real impact on their quality of life well into survivorship.
Further, since data just released this week at the American Psychosomatic Society meeting in Savannah, GA shows that depressive symptoms during breast cancer treatment predict greater odds of mortality over the next 8-15 yrs it is plausible that these cognitive behavioral stress management effects on reduced long-term depressive symptoms may have implications for survival. Finally since depressive symptoms relate to greater signs of inflammation in breast cancer patients and because inflammation promotes cancer disease progression via effects on angiogenesis, invasion and metastasis, then managing depressive symptoms during and after active treatment for breast cancer could have effects on health outcomes via lower inflammation.
Medical Research: What should clinicians and patients take away from your report?
Dr. Antoni: CBSM Techniques such as progressive muscle relaxation and deep breathing techniques along with strategies for changing self-defeating and irrational thoughts about life stressors, a procedure called “cognitive restructuring” can be learned and applied to daily life and breast- cancer specific stressors. We have shown that gaining skills in these techniques are associated with regulation of the adrenal stress hormone cortisol in women under treatment for breast cancer. Since better regulation of cortisol relates to less depression and inflammation this suggests the health value of using these techniques during treatment for breast cancer.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Antoni: Future research is asking whether women who receive CBSM during primary treatment for breast cancer have an improved course of disease over time, and whether changes in depression and psychological adaptation, and cortisol and inflammatory signaling help explain any long-term benefits.
Stagl, J. M., Bouchard, L. C., Lechner, S. C., Blomberg, B. B., Gudenkauf, L. M., Jutagir, D. R., Glück, S., Derhagopian, R. P., Carver, C. S. and Antoni, M. H. (2015), Long-term psychological benefits of cognitive-behavioral stress management for women with breast cancer: 11-year follow-up of a randomized controlled trial. Cancer. doi: 10.1002/cncr.29076
MedicalResearch.com Interview with: Michael H. Antoni, Ph.D (2015). Stress Management Reduces Depression In Breast Cancer