title: Psychosocial telephone counseling for survivors of cervical cancer: results of a randomized biobehavioral trial.
abstract: OBJECTIVE
  Survivors of cervical cancer experience quality-of-life (QOL) disruptions that persist years after treatment. This study examines the effect of a psychosocial telephone counseling (PTC) intervention on QOL domains and associations with biomarkers.
  
  
  METHODS
  We conducted a randomized clinical trial in survivors of cervical cancer, who were ≥ 9 and less than 30 months from diagnosis (n = 204), to compare PTC to usual care (UC). PTC included five weekly sessions and a 1-month booster. Patient-reported outcomes (PROs) and biospecimens were collected at baseline and 4 and 9 months after enrollment. Changes in PROs over time and associations with longitudinal change in cytokines as categorical variables were analyzed using multivariable analysis of variance for repeated measures.
  
  
  RESULTS
  Participant mean age was 43 years; 40% of women were Hispanic, and 51% were non-Hispanic white. Adjusting for age and baseline scores, participants receiving PTC had significantly improved depression and improved gynecologic and cancer-specific concerns at 4 months compared with UC participants (all P < .05); significant differences in gynecologic and cancer-specific concerns (P < .05) were sustained at 9 months. Longitudinal change in overall QOL and anxiety did not reach statistical significance. Participants with decreasing interleukin (IL) -4, IL-5, IL-10, and IL-13 had significantly greater improvement in QOL than those with increasing cytokine levels.
  
  
  CONCLUSIONS
  This trial confirms that PTC benefits mood and QOL cancer-specific and gynecologic concerns for a multiethnic underserved population of survivors of cancer. The improvement in PROs with decreases in T-helper type 2 and counter-regulatory cytokines supports a potential biobehavioral pathway relevant to cancer survivorship.
authors.affiliation: Lari Wenzel, Kathryn Osann, Susie Hsieh, Jo A. Tucker, and Edward L. Nelson, University of California Irvine, Irvine, CA; and Bradley J. Monk, Creighton University School of Medicine at St Joseph's Hospital and Medical Center, Phoenix, AZ. lwenzel@uci.edu.
authors.forename: Lari
authors.initials: L
authors.lastname: Wenzel
authors.affiliation: Lari Wenzel, Kathryn Osann, Susie Hsieh, Jo A. Tucker, and Edward L. Nelson, University of California Irvine, Irvine, CA; and Bradley J. Monk, Creighton University School of Medicine at St Joseph's Hospital and Medical Center, Phoenix, AZ.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Osann
authors.affiliation: Lari Wenzel, Kathryn Osann, Susie Hsieh, Jo A. Tucker, and Edward L. Nelson, University of California Irvine, Irvine, CA; and Bradley J. Monk, Creighton University School of Medicine at St Joseph's Hospital and Medical Center, Phoenix, AZ.
authors.forename: Susie
authors.initials: S
authors.lastname: Hsieh
authors.affiliation: Lari Wenzel, Kathryn Osann, Susie Hsieh, Jo A. Tucker, and Edward L. Nelson, University of California Irvine, Irvine, CA; and Bradley J. Monk, Creighton University School of Medicine at St Joseph's Hospital and Medical Center, Phoenix, AZ.
authors.forename: Jo A
authors.initials: JA
authors.lastname: Tucker
authors.affiliation: Lari Wenzel, Kathryn Osann, Susie Hsieh, Jo A. Tucker, and Edward L. Nelson, University of California Irvine, Irvine, CA; and Bradley J. Monk, Creighton University School of Medicine at St Joseph's Hospital and Medical Center, Phoenix, AZ.
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Monk
authors.affiliation: Lari Wenzel, Kathryn Osann, Susie Hsieh, Jo A. Tucker, and Edward L. Nelson, University of California Irvine, Irvine, CA; and Bradley J. Monk, Creighton University School of Medicine at St Joseph's Hospital and Medical Center, Phoenix, AZ.
authors.forename: Edward L
authors.initials: EL
authors.lastname: Nelson
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology; D003376:Counseling / Q000379:methods*; D016207:Cytokines / Q000097:blood; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D012944:Social Support; D013315:Stress, Psychological / Q000175:diagnosis / Q000523:psychology; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D013689:Telephone; D018418:Th2 Cells / Q000378:metabolism; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000208:ethnology / Q000523:psychology* / Q000628:therapy*; D044465:White People / Q000706:statistics & numerical data
chemical_list: D016207:Cytokines