Prospective Analysis of Stress and Immunity in Advanced Cancer

Objectives:The aims of this study were to assess chronic stress in a sample of advanced cancer patients, test the association between stress and NK cell immune markers over time, and examine whether stress predicts immune markers over time.Methods:A sample of 99 patients were recruited for the study. Patient inclusion criteria were biopsy, radiological, or biological evidence of advanced cancer. Stress was analyzed using the Perceived Stress Scale and immunity was assessed using CD16+ and CD56+ lymphocyte subsets. . Descripitve statistics, Mann-Whitney U tests, and cross-lagged panel analyses were used to test the aims. Results:Mean stress levels were not higher than the general population. Using Mann Whitney U tests, significant differences in CD16 and CD56 were observed between high stress and low stress groups at several time points. Cross-lagged panel analyses also showed that stress predicted abnormal levels of CD16 and CD56s at subsequent time points.Conclusion:Although stress levels among participants was not higher than the general population, for those patients who reported higher levels of stress Mann-Whitney U tests and cross-lagged panel analyses suggested that stress was associated with dysregulation of both CD16+ and CD56+. This dysregulation could decrease the body's defenses to identify and destroy new tumor cells and contribute to the growth of the primary tumor or metastatic spread of the disease. Clinical applications of this study should involve developing interventions that are designed to lower stress in patients with cancer