title: Impact of breast cancer recurrence and cancer-specific stress on spouse health and immune function.
abstract: Spouses of cancer patients are at-risk for poor psychological and physical health as they cope with the complex nature of the disease and fears of losing their partner. Moreover, spouses often serve as patients' primary informal caregivers, a group that evidences poor outcomes across a variety of domains. The present study examines the relative contributions of cancer recurrence - a cancer-specific stressful event - and the subjective experience of cancer-specific stress (IES) in a sample of male spouses of breast cancer survivors. We hypothesized that stress would contribute to poorer physical health and compromised immune function. Spouses (recurrence; n=16) of patients who were coping with their first recurrence were matched to spouses of patients with no evidence of disease (disease-free; n=16). Self-reported physical health (physical symptoms and fatigue) and immune function [T-cell blastogenic response to the mitogens Concanavalin A (ConA) and phytohemagglutanin (PHA) and T3 monoclonal antibody (T3 Mab)] were included as outcomes. Results indicated that patient recurrence status was not a significant unique predictor of physical health or immune function; rather, among all spouses, cancer-specific stress symptoms were associated with increased physical symptoms and altered T-cell blastogenesis. These data suggest that the health implications of caregiving for spouses of cancer survivors is more strongly linked to their subjective experience of cancer as stressful, rather than simply the patients' disease status.
authors.affiliation: Department of Psychiatry, Center for Palliative Care, The Ohio State University, Columbus, OH 43210–1222, USA. sharla.wells@osumc.edu
authors.forename: Sharla Wells-Di
authors.initials: SW
authors.lastname: Gregorio
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Carpenter
authors.forename: Caroline S
authors.initials: CS
authors.lastname: Dorfman
authors.forename: Hae-Chung
authors.initials: HC
authors.lastname: Yang
authors.forename: Laura E
authors.initials: LE
authors.lastname: Simonelli
authors.forename: William E
authors.initials: WE
authors.lastname: Carson
mesh_terms: D001943:Breast Neoplasms / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D007109:Immunity; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012959:Socioeconomic Factors; D018454:Spouses / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology*