[Consenting and declining patients for an intervention group after breast cancer surgery differ in terms of quality of life, coping and immunological functional assays].
OBJECTIVE
Psychosocial intervention during the course of cancer is still being controversially disputed in psychosomatic studies. Immunological and endocrinological parameters can serve as links in observing the influence of the interactive processes involved.


METHODS
The approach to determine whether psychotherapeutic intervention can lead to an improved quality of life on the one hand, and to a change in immune defenses in breast cancer patients as well, employed using the EORTC QLQ-C30 and optimistic self-efficacy (OKE) as well as evaluating lymphocyte subpopulations, lymphocyte proliferation and NK cell activity. Fifty-three breast cancer patients were offered the chance to participate in a psychosocial intervention group. Twenty-three accepted the offer. Randomized sampling of the group participants was determined twice by using the 30 EORTC QLQ-C30 parameters. In addition, immune function was measured before beginning (T1) and after completing the group intervention sessions (T2). This data was compared with that of the declining group.


RESULTS
The analysis of the individual EORTC parameters in the pre- and post-comparison showed a decrease in "emotional strain" and an increase in "all-around quality of life" at the T2 test period. NK cell activity was increased at T2 as well in the participating group and was higher than that of the declining group both at T1 and T2 testing times.


CONCLUSIONS
Participation in the psychosocial intervention group resulted in a marked decrease in the emotional strain and an increase in the quality of life. The increased NK-cell activity with lowered T-cell activation in comparison to the decliners hints at a coherence between coping behaviour and changes of the immunological cell function. The results of this study will be investigated further in a greater sample.
Neises
M
M
Frauenklinik Universitätsklinikum Mannheim.
Ditz
S
S
Scheck
T
T
Schiller
A
A
Nebe
C T
CT
D000223:Adaptation, Psychological; D001943:Breast Neoplasms / Q000276:immunology / Q000523:psychology* / Q000534:rehabilitation / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007694:Killer Cells, Natural / Q000276:immunology; D008213:Lymphocyte Activation; D008214:Lymphocytes / Q000145:classification / Q000276:immunology*; D008408:Mastectomy / Q000523:psychology* / Q000534:rehabilitation; D008875:Middle Aged; D010349:Patient Compliance; D018579:Patient Selection; D011613:Psychotherapy; D011788:Quality of Life; D016312:Treatment Refusal