Stress and the Immune System To date, the field of psychoneuro-immunology has yielded relatively little data related to cancer. In the area of infectious diseases, particularly colds, researchers have found a variety of links between psychological stress and the immune system. A few investigators have looked specifically at cancer patients and how the stress of diagnosis and treatment may affect immune response. Barbara Andersen, PH.D., and colleagues at Ohio State University (Columbus) are conducting randomized clinical trials on support-group interventions with breast cancer patients. They report that "baseline measures of stress, specific to the diagnosis of cancer, were linked to levels of natural killer cell activity, T-cell responses, and other cellular responses relevant to cancer prognosis." Anderson hopes to find out if stress reduction intervention can influence cancer progression. Anderson’s study involves 235 women with stage II or III breast cancer who are randomized, after surgery and before adjuvant therapy, into two groups. One of these groups will attend support groups for a year. The group sessions emphasize emotional support, education and coping strategies. All participants are assessed, first at enrollment and then five years following randomization to determine stress levels, cellular immune responses, and cancer recurrence. Recruitment was expected to be completed in 1998 with results available in about six years. Locally, Dr. David Spiegel and colleagues have also been studying the effects of support groups and survival. His study initiated in 1990 is now about three-quarters of the way through a 10-year follow-up. The investigators are monitoring endocrine and cellular markers of immune function, such as cortisol levels and natural killer cell activity, as well as recurrence and survival rates. Final results, including survival data, could be ready around the year 2000.
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