Cancer Control Research5R01CA064710-14
Antoni, Michael Howard
FACILITATING POSITIVE ADAPTATION TO BREAST CANCER
Our recent randomized trial tested the efficacy of a 10-week cognitive behavioral stress managemen (CBSM) intervention in women with breast cancer. We examined whether the intervention facilitate "recovery" or adaptation after adjuvant therapy had been completed. Intervention participants showe improvements in multiple indicators of psychosocial adaptation (less intrusive thoughts and social disruption greater benefit finding, positive affect, and positive states of mind), physiological adaptation (decrease cortisol and increased cellular immune function and Th1 cytokine production) and physical adaptation (les fatigue and improved sleep quality). We found evidence that one specific element of the multi-modal CBS intervention?the perception of being able to use learned exercisesto relax on demand?appeared t mediate the effects of the intervention on many of the outcomes. However, we found that many women ar unable to attend groups for the full 10-week period due to family responsibilities, work demands and differen physical factors (e.g., fatigue). We also know that those attending approximately half of the sessions d experience treatment gains. This suggests that shorter forms of the intervention, focusing on elements of th full intervention such as cognitive behavioral therapy techniques or on relaxation training skills might be cost-effective way to facilitate adaptation among a larger portion of the population of women receivin treatment for breast cancer. For this competitive renewal, we propose to test two active treatment condition (a 5-week version of cognitive behavioral (CB) and a 5-week relaxation training (RT) intervention) and a 5 week attention-social support control. Thus, 240 (after attrition) White, Hispanic (both English- and Spanish speaking), and Black women who are newly diagnosed with Stages l-lll breast cancer will be randomized t 5-week CB (N = 80), 5-week RT-only (N = 80) or a attention control (N = 80), and monitored across indice of adaptation at 6 months and 12 months after the intervention. The interventions are hypothesized t improve psychosocial adaptation (benefit finding, positive affect, positive states of mind, thought intrusions depression, and better social and psychosexual functioning), decrease stress (lower cortisol) and improv immune function and physical adaptation (less fatigue and sleep disruption and better physical quality of life).