Hormone, Psychologic &amp; Immunologic Factors &amp; BC Survivorship
Creators: name: University Of California Office Of The President
Publisher: name: University of California Office of the President
publisherIdentifier: https://ror.org/00dmfq477
publisherIdentifierScheme: ROR
Year: 2024

description: Breast cancer follow-up research has focused solely on documenting distress and dysfunction; however, cancer survivors exhibit similar or better adjustment compared with medical and healthy controls. Approximately 60-90% of breast cancer survivors report beneficial changes, including greater life appreciation and meaning. Positive and negative outcomes are not mutually exclusive, which supports a multidimensional conceptualization of adjustment in which health and dysfunction may exist. The purpose of "Looking forward to LIFE" is to investigate the relationship between the Luteal phase, Immunologic Factors, and Emotional stress, to maximize breast cancer survivorship. 
 
 
 
 
 
 
 
 This will be the first study to date to investigate the role that sex hormones (i.e., estrogen, progesterone, FSH, LH) at the time of surgery, procedural and chronic stress (i.e., cortisol), and the immune system (i.e. natural killer cells) play in predicting health/recurrence in breast cancer survivors. The major hypothesis of this new prospective study is to determine whether timing of surgery during the luteal phase, low procedural and lifetime stress, and higher Natural Killer Cell Activity may interact, thereby increasing breast cancer survival. There are five aspects of this hypothesis that we will examine in detail:
 
 
 
 -The phase of the menstrual cycle and procedural stress (cortisol) measured 
 
 at the time of surgery may predict survivorship (i.e., health, recurrence, 
 
 metastases, death).
 
 -Lifetime stress and timing of surgery may also affect survival.
 
 -High quality social support, coping responses, optimistic attitude, and 
 
 quality of life will contribute to a healthy outcome vs. breast cancer recurrence 
 
 during the study period.
 
 -NK cell activity (NKCA) will be higher at pre-surgery in subjects who 
 
 remain healthy compared to those who experience a recurrence.
 
 -Optimism, strong social support, coping skills, and quality of life will 
 
 have an influence on NKCA.
 
 -Procedural and lifetime stress, phase of menstrual cycle during surgery, 
 
 stress hormones and immunologic factors (NKCA) may all contribute to breast 
 
 cancer survivorship.
 
 
 
 The study sample will consist of 450 White, African-American, Hispanic, Asian, and Pacific Islander women undergoing surgery for primary carcinoma of the breast, recruited from 5 sites in California and one in New York. Each woman will participate in a telephone interview, complete standardized psychological questionnaires, and provide blood samples (for NKCA analyses), urine (e.g., for sex hormones and cortisol [acute stress]) and saliva (for cortisol [chronic stress]) at study entry, 1 month, 3 months, time of recurrence (if applicable), and at completion of study. 
 
 
 
 
 
 
 
 From the previous CBCRP study, we determined that surgery during the follicular phase of the menstrual cycle was detrimental to long-term survival. Chronic emotional stress has also been associated with both impaired immune surveillance functions (NKCA) and stress hormone levels. Stress also alters menstrual phase length. If there is a relationship between hormones, psychological, and immunologic factors and survivorship, the positive impact of longer survival and less recurrence, as well as economic savings would be enormous. The clinical application of this study would be to schedule women's surgery according to the menstrual cycle, counsel them to modify their lifetime and acute (procedural) stress, strengthen their optimism, support system, coping skills, and quality of life, which may enhance their immune system, and ultimately provide them with knowledge that could maximize survivorship.