title: Stress and immune responses after surgical treatment for regional breast cancer.
abstract: BACKGROUND
  Adults who undergo chronic stress, such as the diagnosis and surgical treatment of breast cancer, often experience adjustment difficulties and important biologic effects. This stress can affect the immune system, possibly reducing the ability of individuals with cancer to resist disease progression and metastatic spread. We examined whether stress influences cellular immune responses in patients following breast cancer diagnosis and surgery.
  
  
  METHODS
  We studied 116 patients recently treated surgically for invasive breast cancer. Before beginning their adjuvant therapy, all subjects completed a validated questionnaire assessing the stress of being cancer patients. A 60-mL blood sample taken from each patient was subjected to a panel of natural killer (NK) cell and T-lymphocyte assays. We then developed multiple regression models to test the contribution of psychologic stress in predicting immune function. All regression equations controlled for variables that might exert short- or long-term effects on these responses, and we also ruled out other potentially confounding variables.
  
  
  RESULTS
  We found, reproducibly between and within assays, the following: 1) Stress level significantly predicted lower NK cell lysis, 2) stress level significantly predicted diminished response of NK cells to recombinant interferon gamma, and 3) stress level significantly predicted decreased proliferative response of peripheral blood lymphocytes to plant lectins and to a monoclonal antibody directed against the T-cell receptor.
  
  
  CONCLUSIONS
  The data show that the physiologic effects of stress inhibit cellular immune responses that are relevant to cancer prognosis, including NK cell toxicity and T-cell responses. Additional, longitudinal studies are needed to determine the duration of these effects, their health consequences, and their biologic and/or behavioral mechanisms.
authors.affiliation: Department of Psychology, Institute for Behavioral Medicine Research,The Ohio State University, Columbus 43210-1222, USA. Andersen.1@osu.edu
authors.forename: B L
authors.initials: BL
authors.lastname: Andersen
authors.forename: W B
authors.initials: WB
authors.lastname: Farrar
authors.forename: D
authors.initials: D
authors.lastname: Golden-Kreutz
authors.forename: L A
authors.initials: LA
authors.lastname: Kutz
authors.forename: R
authors.initials: R
authors.lastname: MacCallum
authors.forename: M E
authors.initials: ME
authors.lastname: Courtney
authors.forename: R
authors.initials: R
authors.lastname: Glaser
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000494:pharmacology; D001943:Breast Neoplasms / Q000276:immunology* / Q000523:psychology* / Q000601:surgery; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000494:pharmacology; D007694:Killer Cells, Natural / Q000187:drug effects / Q000276:immunology; D008875:Middle Aged; D011237:Predictive Value of Tests; D011994:Recombinant Proteins / Q000494:pharmacology; D012044:Regression Analysis; D015203:Reproducibility of Results; D013315:Stress, Psychological / Q000276:immunology*; D013601:T-Lymphocytes / Q000187:drug effects / Q000276:immunology
chemical_list: D000970:Antineoplastic Agents; D011994:Recombinant Proteins; D007371:Interferon-gamma