How do psychological factors interact with the oncological outcomes of women with triple-negative breast cancer?
- Conditions
- C50Malignant neoplasm of breast
- Registration Number
- DRKS00023519
- Lead Sponsor
- Carl von Ossietzky Universität Oldenburg
- Brief Summary
Biological and physiological changes in response to stress are crucial to adapting to environmental constraints. Typical stress responses activate the sympathetic nervous system and the hypothalamic-pituitary-adrenal cortical axis, which aim to maintain homeostasis in response to demands and influence various biological responses at neuroendocrine, cellular, and immune levels. In particular, there is compelling evidence showing the devastating effects of high-stress levels on immune responses and brain functionality. In that sense, data suggest that a sustained stress-physiological response predicts decreases in immunity and leads to allostatic load, the wear and tear of biological systems. Similarly, in cancer research, chronic stress levels have been reported to impair the body-surveillance systems and be related to cancer incidence, progression, and mortality. Despite the evidence demonstrating the associations between stress and cancer, there are limited data on whether lifetime stress exposure relates to clinical indicators of cancer aggressiveness. Considering the evidence showing the adverse effects of prolonged stress exposure on cancer disease, this thesis aimed to explore the relationship between lifetime stress exposure and the clinical characteristics of tumor-aggressiveness in a cohort of patients affected with triple-negative breast cancer (TNBC). Likewise, as research has shown that coping responses moderate the stress-physiological response, we aimed to investigate the role of coping responses in moderating the association between tumor aggressiveness and lifetime stress exposure. According to the scientific literature, high-stress levels would increase physiological arousal and allostatic load favoring a debilitated immune system. Thus, we hypothesized finding positive associations between lifetime stress exposure and tumor-aggressiveness. In the same line, we suspected that adaptative coping styles would be negatively related to tumor-aggressiveness. The participants of this study were 29 women diagnosed with TNBC who were treated in the University Hospital for Gynecology Pius-Hospital (Oldenburg, Germany). Correlation and moderation regression analyses with the use of composite scores were conducted. Overall, we could not demonstrate significant associations between lifetime stress exposure and coping responses on the clinical indicators of tumor aggressiveness in this cohort of patients. Possible explanations for these results are discussed, and suggestions for future research are provided. This study was the first to investigate the effect of lifetime stress exposure and coping response on the aggressive tumor characteristics of TNBC. We provided a deep theoretical framework to understand the interplay between biological and psychological aspects of cancer disease, and we hope that our recommendations may serve as a base for upcoming studies.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Complete
- Sex
- Female
- Target Recruitment
- 29
Female sex, confirmed diagnosis of TNBC, the ability to speak and understand German, andthe ability to give informed consent.
An unconfirmed TNBC diagnosis, woman whose medical records are lacking clinical and/or pathological variables of interest, a current or previous mood disorder, psychosis, anxiety disorder, psychosis, anxiety disorder, or substance abuse disorder according to the DSM V, Diagnostic and Statistical Manual of Mental Disorders, and/or current use of psychotropic agents or psychiatric drugs.
Study & Design
- Study Type
- observational
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method The primary objective of the pilot study is to generate the planning assumptions and hypotheses for a subsequent prospective study, in which the primary hypothesis will examine the influence of psychological factors on the oncological outcomes of patients with TNBC. More precisely, the effect of cumulative lifetime stress on TNBC recurrence will be investigated. Cumulative lifetime stress will be quantified as a score (Overall Severity Score; OSS) derived from the Stress and Adversity Inventory (STRAIN) questionnaire (Slavich and Shields, 2018). TNBC recurrence will be assessed in terms of free of disease period (FDP).
- Secondary Outcome Measures
Name Time Method The secondary objectives are 1) to assess the following psychological aspects of patients: coping response, social support, and well-being, 2) to estimate the hazard ratios (HR) associated with the psychological variables, 3) to describe the study population according to their clinical characteristics at the time of diagnosis, 4) to describe the tumor stage and tumor biological characteristics of the study population (stadium, histopathology, grade, receptor status, DNA assay, etc.).