Pre-Surgery De-Stressing Improves Immune Outcomes in Prostate Cancer Patients
Researchers from MD Anderson Cancer Center at the University of Texas, Houston, assessed whether stress management (SM) improved immune outcomes in men undergoing surgery for prostate cancer.
A total of 159 men were assigned randomly to a two-session pre-surgical stress management intervention, a two-session supportive attention (SA) group, or a standard care (SC) group.
Men in the SM group discussed their concerns about the upcoming surgery and were taught diaphragmatic breathing, guided imagery, imaginal exposure to the day of surgery and additionally learned adaptive coping skills.
Men in the SA group discussed their concerns about the upcoming surgery and had a semistructured medical interview.
Blood samples were collected at baseline (1 month before surgery) and 48 hours after surgery. Measures of mood (Profile of Mood States) were collected at baseline, 1 week pre-surgery, and the morning of surgery.
Men in the SM group had significantly higher levels of natural killer cell cytotoxicity (p = .04) and higher levels of circulating proinflammatory cytokines (interleukin [IL]-12p70, p = .02; IL-1β, p = .02; tumor necrosis factor-α, p = .05) 48 hours post surgery, than men in the SA group; and higher levels of natural killer cell cytotoxicity (p = 0.02) and IL-1β (p = .05) than men in the SC group.
Immune parameters increased for the SM group and decreased or stayed the same for the SA and SC groups. The SM group had significantly lower Profile of Mood States scores than the SC group (p = .006), with no other group differences between SA and SC groups. Changes in mood were not associated with immune outcomes.
The study found that stress management leads to decreased presurgical mood-disturbance and increased immune parameters after surgery. This supports the hypothesis of potential psychological and biological benefits of pre-surgically administered stress management.
Citation: Cohen L, Parker PA, Vence L, Savary C, Kentor D, Pettaway C, Babaian R, Pisters L, Miles B, Wei Q, Wiltz L, Patel T, Radvanyi L. Presurgical stress management improves postoperative immune function in men with prostate cancer undergoing radical prostatectomy. Psychosomatic Medicine. 2011 Apr;73 (3)pages :218-25. Epub 2011 Jan 21. [email protected]