Prolonged cancer-related distress is associated with elevated inflammation during breast cancer survivorship

Abstract

Cancer-related distress is common among breast cancer survivors prior to treatment and is associated with adverse health effects. Moreover, many survivors continue to experience distress after treatment ends, and the impact of prolonged cancer-related distress on health is unknown. The aim of the current study was to investigate the effects of cancer-related distress on inflammation changes among breast cancer survivors. In a parent study, survivors stages 0-IIIC(N = 126) provided data prior to primary cancer treatment (i.e., surgery, radiation, or chemotherapy) and 18 months post-treatment. The current study utilized the Impact of Events Scale-Revised (IES-R) and proinflammatory cytokine interleukin-6 (IL-6). Cross-sectional analyses indicated that women reporting more cancer-related distress 18-months post- treatment evidenced greater inflammation compared to those with lower distress (b = 0.009, SE = 0.004, p = .050). Additionally, women who experienced greater declines in cancer-related distress evidenced smaller IL-6 increases from pre to post-treatment (b = 0.007, SE = 0.003, p = .041). Follow-up analyses indicated that changes in avoidance were related to changes in inflammation (b = 0.014, SE = 0.005, p = .010), but changes in intrusive thoughts were not (b = 0.005, SE = 0.006, p = .453). Women who experience prolonged cancer-related distress, and avoidant emotional coping in particular, may experience more persistent inflammation during survivorship, leaving them vulnerable to increased risk of recurrence and morbidity.