Improving biobehavioral health in younger breast cancer survivors: Pathways to Wellness trial secondary outcomes

Author:

Bower Julienne E1234ORCID,Partridge Ann H56,Wolff Antonio C7,Cole Steve W2348,Irwin Michael R1234,Thorner Elissa D7,Joffe Hadine91011ORCID,Petersen Laura4ORCID,Crespi Catherine M412,Ganz Patricia A4813

Affiliation:

1. Department of Psychology, University of California, Los Angeles , Los Angeles, CA, USA

2. Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles , Los Angeles, CA, USA

3. Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles , Los Angeles, CA, USA

4. Jonsson Comprehensive Cancer Center, University of California, Los Angeles , Los Angeles, CA, USA

5. Department of Medical Oncology, Dana Farber Cancer Institute , Boston, MA, USA

6. Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School , Boston, MA, USA

7. The Johns Hopkins University School of Medicine and Sidney Kimmel Comprehensive Cancer Center , Baltimore, MD, USA

8. Department of Medicine (Hematology-Oncology), David Geffen School of Medicine, University of California, Los Angeles , Los Angeles, CA, USA

9. Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Harvard Medical School , Boston, MA, USA

10. Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School , Boston, MA, USA

11. Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute , Boston, MA, USA

12. Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles , Los Angeles, CA, USA

13. Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles , Los Angeles, CA, USA

Abstract

Abstract Background The Pathways to Wellness trial tested the efficacy of 2 interventions for younger breast cancer survivors: mindful awareness practices (MAPs) and survivorship education (SE). This planned secondary analysis examines intervention effects on stress, positive psychological outcomes, and inflammation (Clincaltrials.gov NCT03025139). Methods Women diagnosed with breast cancer at or before age 50 years who had completed treatment and had elevated depressive symptoms were randomly assigned to 6 weeks of MAPs, SE, or wait-list control (WLC). Assessments conducted at pre- and postintervention and at 3- and 6-month follow-up measured general stress perceptions, cancer-related intrusive thoughts and worry, positive affect, meaning and peace in life, altruism and empathy, and markers of inflammation. Analyses compared change in outcomes over time in each intervention group relative to WLC using linear mixed models. Results A total 247 women were randomly assigned to MAPs (n = 85), SE (n = 81), or WLC (n = 81). MAPs statistically significantly decreased intrusive thoughts and worry at postintervention and 3-month follow-up relative to WLC (P < .027) and statistically significantly increased positive affect and meaning and peace at postintervention, with positive affect persisting at 3-month follow-up (P < .027). SE statistically significantly decreased intrusive thoughts at 3-month follow-up and statistically significantly increased positive affect at 6-month follow-up relative to WLC (P < .01). Proinflammatory gene expression increased in WLC relative to MAPs (P = .016) but did not differ from SE. There were no intervention effects on other outcomes. Conclusion MAPs had beneficial effects on psychological and immune outcomes in younger breast cancer survivors and is a promising approach for enhancing biobehavioral health.

Funder

National Cancer Institute

National Institutes of Health

National Center for Advancing Translational Science

Breast Cancer Research Foundation

BCRF Scientific Advisory Board

Komen Foundation

Publisher

Oxford University Press (OUP)

Subject

Cancer Research,Oncology

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