Researchers said the University of Texas in the Anderson Cancer Center, located in Houston, and Baylor College of medicine created a study to determine whether stress management improved the outcomes in men undergoing surgery for prostate cancer. A group of 169 man were assigned randomly to a two session pre-surgical stress management. Intervention, at two session port of attention group.
Researchers at the University of Texas MD Anderson Cancer Center have found that practicing stress management techniques before prostate cancer surgery can enhance the body's immune response leading to quicker recovery, as well as aid in lowering mood disturbance.
This is the first study to evaluate the effects of stress management before surgery and its impact on the immune system in men with prostate cancer undergoing radical prostatectomy i.e. all of the prostate gland.
The study is published in the February/March edition of the Journal Psychosomatic Medicine. In an earlier study, the researchers reported significantly less mood disturbances and improve quality of life one year later in men see this training prior to surgery.
Stress May Help Cancer Cells Resist Treatment
Wake Forest University School of Medicine scientists are the first to report that the stress hormone epinephrine causes changes in prostate and breast cancer cells that may make them resistant to cell death.
"These data imply that emotional stress may contribute to the development of cancer and may also reduce the effectiveness of cancer treatments," said George Kulik, D.V.M., Ph.D., an assistant professor of cancer biology and senior researcher on the project.
Levels of epinephrine, which is produced by the adrenal glands, are sharply increased in response to stressful situations and can remain continuously elevated during persistent stress and depression, according to previous research. The goal of the current study was to determine whether there is a direct link between stress hormones and changes in cancer cells.
While a link between stress and cancer has been suggested, studies in large groups of people have been mixed. "Population studies have had contradictory results," said Kulik. "We asked the question, 'If stress is linked to cancer, what is the cellular mechanism?' There had been no evidence that stress directly changes cancer cells."
Studying prostate and breast cancer cells in the laboratory, Kulik and colleagues found that a protein called BAD -- which causes cell death -- becomes inactive when cancer cells are exposed to epinephrine.
Kulik said that connection between stress and prostate cancer has been largely unexplored. However, recent studies suggest that these laboratory findings may apply to cancer patients.
"A study from Canada showed that men who took beta blockers for hypertension for at least four years had an 18 percent lower risk of prostate cancer," said Kulik. "These drugs block the effects of epinephrine, which could explain the finding.
Another study of men after radical prostatectomy reported increased mood disturbances, which are often associated with elevated stress hormones. Although these studies do not directly address the role of stress hormones, they suggest that stress hormones may play an important role in prostate cancer."
Kulik said the findings have several implications for patients and for researchers. "It may be important for patients who have increased responses to stress to learn to manage the effects," said Kulik. "And, the results point to the possibility of developing an intervention to block the effects of epinephrine."
He is now examining blood samples of prostate cancer patients to determine if there is a link between levels of stress hormones and severity of disease and has begun studying the effects of epinephrine in mice with prostate cancer.
The study results are reported on-line in the Journal of Biological Chemistry and will appear in a future print issue. Funding for the study came from the Defense Department's prostate cancer research program, the Wake Forest University School of Medicine venture fund and the Wake Forest Comprehensive Cancer Center.
Co-researchers were Konduru Sastry, Ph.D., lead author, Yelena Karpova, B.S., Sergey Prokopovich, M.D., Ph.D., Adrienne Joy Smith, B.S., Brian Essau, Ph.D., Ph.D., Thomas Register, Ph.D., Yong Chen, Ph.D., and Raymond Penn, Ph.D., all with Wake Forest; and Avynash Gersappe, M.B.A., Jonathan Carson, Ph.D., and Michael Weber, Ph.D., from the University of Virginia.
"Men who face prostatectomy as treatment for prostate cancer often have high stress levels about the procedure and the potential effects on their quality of life," said Lorenzo Cohen, Ph.D., the study's senior author and professor in MD Anderson's Departments of General Oncology and Behavioral Science. "Both the physical and psychological stress of surgery can be harmful to the immune system. Even brief pre-surgery sessions of stress management positively impact on the recovery process, both in terms of psychological and immunological outcomes," he said.
Surgery is a very stressful experience and can trigger a powerful physiological and biochemical inflammatory response near the e surgery site and throughout the body, elevating certain cell-signaling proteins called cytokines that increase inflammation and suppress the immune response. Psychological stress interrupts cytokine function, reduces the function of natural killer cells and slows wound healing.
While the elevation of inflammatory cytokines may be harmful if sustained, short-term increases before and after surgery may signal an immune response that helps wounds heal and recover.
Participants received different levels of intervention. The participants were 159 men with early-stage prostate cancer who were scheduled for radical prostatectomy were randomized into three groups.
The men in the stress management group met twice with a psychologist one to two weeks before surgery to discuss concerns and were taught some
guided imagine and deep breathing techniques to help them cope with the potential effects of surgery. They were guided through visualization exercises to help prepare for surgery and hospitalization.
They also were given a stress management guide that built upon the sessions and audiotapes of techniques to practice on their own.
They had a short booster sessions with the psychologist on the morning of the surgery. Two days post operatively they had a brief session to reinforce relaxation and coping strategies.
The participants in the Supportive attention group, one or two weeks prior to surgey met with a psychologist. Sessions were supportive and included a semi-structured psychosocial and medical history in an interview format. In an encouraging environment they were provided empathy and the opportunity to share their concerns.
And two days before surgery they had a short session to discuss their pre-surgical experiences. Two days after their surgery had another short session to
discuss their experiences before surgery and during their hospital care.
While the standard care group did not meet with psychologists and received standard medical care.
Blood samples were collected from each patient about a month before surgery and 48 hours after surgery. Patient mood was measured about a month before surgery, a week before surgery (after the interventions) and the morning of the surgery.
Intevention Benefits Measured
Two days after surgery, the men in the stress management group had a better functioning immune system, compared to the men in the other group.
If you want to prepare for surgery or lower your stress in general, click here now and get our free healing meditation.
Yours in good health,
Elaine R. Ferguson, MD