Does subjective burden of early breast cancer and its treatment affect immune measures during adjuvant therapy?

Marzio E E Sabbioni, Jürg Bernhard, Hans Peter Siegrist, Shu Fang Hsu Schmitz, Monica Castiglione Gertsch, Beat Thürlimann, Hervé Bonnefoi, Lucien Perey, Richard Herrmann, Aron Goldhirsch, Christoph Hürny

Research output: Contribution to journalArticle

Abstract

Psychosocial factors have been described as affecting cellular immune measures in healthy subjects. In patients with early breast cancer we explored bi-directional psycho-immune effects to determine whether subjective burden has an impact on immune measures, and vice versa. Patients (n = 239) operated for early breast cancer and randomized into International Breast Cancer Study Group (IBCSG) adjuvant clinical trials were assessed immediately before the beginning of adjuvant treatment (baseline) and 3 and 6 months thereafter, at the beginning of the corresponding treatment cycle. Cellular immune measures (leukocytes, lymphocytes, lymphocyte subset counts), markers of activation of the cellular immune system (β2-microglobulin, soluble interleukin-2 receptor serum levels), and self-report subjective burden (global indicators of physical well-being, mood, coping effort) were assessed concurrently. The relationship between subjective burden and gradients of immune measures was investigated with regression analyses controlling for adjuvant treatment. There was a pattern of small negative associations between all variables assessing subjective burden before the beginning of adjuvant therapy with the gradients of the markers of activation of the cellular immune system and NK cell counts. In particular, better mood predicted a decline in the course of β2- microglobulin and IL-2r at months 3 and 6. The gradient of β2- microglobulin was associated with mood and coping effort at month 3. However, the effect sizes were very small. In conclusion, in this explorative investigation, there was an indication for subjective burden affecting and being affected by markers of activation of the cellular immune system during the first 3 and 6months of adjuvant therapy. The question of clinical significance remains unanswered. These associations have to be investigated with refined assessment tools and schedules.

Original languageEnglish
Pages (from-to)75-86
Number of pages12
JournalBreast Cancer Research and Treatment
Volume87
Issue number1
DOIs
Publication statusPublished - Sep 2004

Keywords

  • adjuvant treatment
  • breast cancer
  • burden
  • distress
  • psycho-immunology
  • quality of life

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Sabbioni, M. E. E., Bernhard, J., Siegrist, H. P., Schmitz, S. F. H., Gertsch, M. C., Thürlimann, B., Bonnefoi, H., Perey, L., Herrmann, R., Goldhirsch, A., & Hürny, C. (2004). Does subjective burden of early breast cancer and its treatment affect immune measures during adjuvant therapy? Breast Cancer Research and Treatment, 87(1), 75-86. https://doi.org/10.1023/B:BREA.0000041584.53863.a7