Mindfulness Based Stress Reduction for Psycho-Immune Dysregulation in Cancer

基于正念的减压治疗癌症心理免疫失调

基本信息

批准号：
8281711
负责人：
Linda Janusek
金额：
$ 43.11万
依托单位：
LOYOLA UNIVERSITY CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-08-01 至 2014-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8281711
关键词：
Affect Aftercare American Anxiety Breast Cancer Treatment Cancer Etiology Cancer Patient Cancer Survivorship Catecholamines Cause of Death Cessation of life Diagnosis Disease Distress Early treatment Educational process of instructing Effectiveness Emotions Endocrine Enrollment Evaluation Exhibits Fright Health Hormones Hydrocortisone Hypothalamic structure Immune Immune response Immunosuppression Impairment Individual Intervention Malignant Neoplasms Matched Group Mediation Mind-Body Intervention Modeling Natural Killer Cells Nature Neoplasm Metastasis Neurosecretory Systems Operative Surgical Procedures Outcome Pattern Phase Physiological Pituitary Gland Plasma Population Primary Neoplasm Production Proliferating Psychological Stress Psychoneuroimmunology Publishing Quality of life Radiation therapy Randomized Reporting Research Design Salivary Sampling Science Sleep Staging Stress System Testing Time Uncertainty Woman Women&apos s Group biological adaptation to stress breast cancer diagnosis cancer care cancer diagnosis cancer recurrence cancer therapy cohort comparative coping critical period cytokine design experience health related quality of life immune activation immune function improved malignant breast neoplasm meetings mindfulness-based stress reduction neoplastic cell programs psychologic psychosocial response restoration skills social stem survivorship tumor tumor growth tumor initiation tumor progression

项目摘要

DESCRIPTION (provided by applicant): Breast cancer is the second leading cause of cancer death in American women, with over 39,000 women dying of breast cancer yearly. Breast cancer diagnosis and treatment cause psychosocial distress, disrupted social relationships, anxiety, poor sleep, uncertainty, and fear of cancer recurrence. This distress can extend beyond treatment and adversely affect health-related quality of life (HRQOL). Interventions that stem the tide of negative emotions and their physiological sequelae are needed. Psychoneuroimmunology (PNI) has established that psychosocial distress impairs immune function. We have shown that women diagnosed with breast cancer have significant psychosocial distress that is accompanied by dysregulated natural killer cell activity (NKCA) and cytokine production. These observations are especially important in that impairment of these forms of immune function is associated with increased tumor initiation, primary tumor growth and tumor metastasis. Metastatic disease is the primary cause of death from breast cancer. Mindfulness based stress reduction (MBSR) is a mind-body intervention that shows promise for management of the distress associated with cancer. We show that MBSR reduces neuroendocrine stress activation and improves immune function and quality of life of breast cancer patients during the vulnerable period of cancer diagnosis and treatment. Using a randomized controlled design, this study will evaluate the potential benefits of MBSR on psychosocial distress, neuroendocrine stress activation, immune function, and HRQOL. Women with early stage breast cancer will be randomized to an 8-week MBSR intervention or a control condition. Assessments of immune function (NKCA and cytokines), neuroendocrine activity (salivary cortisol and plasma catecholamines), psychosocial response, and HRQL will be obtained pre-, mid-, at completion, and post-MBSR. Hypotheses will test whether MBSR can improve the psychosocial response of women to breast cancer diagnosis and treatment, reduce neuroendocrine stress activation, restore immune function, and increase HRQOL. The relationship among main study variables will be explored by mediation model testing. These assessments will be achieved during the critical period of cancer diagnosis and treatment when restoration of immune function is most significant. Understanding the trajectory and the nature of the psycho-endocrine-immune response to a promising mind-body approach like MBSR, using a rigorous design in a well-defined cancer population, will significantly contribute to the science of PNI and to integrative cancer care. PUBLIC HEALTH RELEVANCE: Alternative or complementary approaches that enhance the quality of life of women with breast cancer have grown in popularity. Yet, there is a lack of empirical analysis of such approaches using rigorous scientific design. The proposed study will so evaluate one such approach, mindfulness based stress reduction, in a population of women with breast cancer and in comparison to a matched group of women without cancer.

描述（由申请人提供）：乳腺癌是美国妇女癌症死亡的第二大原因，每年有39,000多名妇女死于乳腺癌。乳腺癌的诊断和治疗会导致社会心理困扰，社会关系中断，焦虑，睡眠不佳，不确定性以及对癌症复发的恐惧。这种困扰可以超越治疗，并对与健康相关的生活质量（HRQOL）产生不利影响。需要采取干预措施，这些干预需要消极情绪及其生理后遗症的潮流。 PsychOneuromumumumumanology（PNI）已经确定，心理社会遇险会损害免疫功能。我们已经表明，被诊断出患有乳腺癌的妇女患有严重的社会心理困扰，伴随着自然杀伤细胞活性（NKCA）和细胞因子产生的失调。这些观察结果尤为重要，因为这些形式的免疫功能受损与肿瘤起始，原发性肿瘤生长和肿瘤转移有关。转移性疾病是乳腺癌死亡的主要原因。基于正念的压力减轻（MBSR）是一种思维体干预，显示出对与癌症相关的困扰的有望。我们表明，MBSR在癌症诊断和治疗时期降低了神经内分泌胁迫的激活，并改善乳腺癌患者的免疫功能和生活质量。使用随机对照设计，本研究将评估MBSR对社会心理困扰，神经内分泌压力激活，免疫功能和HRQOL的潜在益处。患有早期乳腺癌的妇女将被随机分为8周的MBSR干预或控制状况。免疫功能（NKCA和细胞因子），神经内分泌活性（唾液皮质醇和血浆儿茶酚胺），心理社会反应和HRQL的评估，将在完成前，MID，MID，完成后以及MBSR获得。假设将测试MBSR是否可以改善妇女对乳腺癌诊断和治疗的社会心理反应，减少神经内分泌压力激活，恢复免疫功能和增加HRQOL。主要研究变量之间的关系将通过中介模型测试探索。当免疫功能的恢复最为重要时，将在癌症诊断和治疗的关键时期进行这些评估。了解心理内分泌 - 免疫反应对有前途的思维方式（如MBSR）的轨迹和性质，在明确定义的癌症人群中使用严格的设计将极大地促进PNI科学和综合癌症护理。公共卫生相关性：增强乳腺癌女性生活质量的替代或互补方法已越来越受欢迎。然而，使用严格的科学设计对这种方法缺乏经验分析。拟议的研究将评估一种这种方法，基于正念的压力减轻，与一群没有癌症的女性相比，乳腺癌妇女人群中的一种基于正念的压力减轻。