A stress-management program for women with breast cancer can alter tumor-promoting processes at the molecular level, according to the team of researchers that designed the group-based Cognitive-Behavioral Stress Management (CBSM) intervention.

Developed at the University of Miami (UM) in Miami, Florida, CBSM combines relaxation, imagery, and deep breathing with cognitive behavior therapy. Cognitive behavior therapy helps participants change the way they address intrusive stressful thoughts, decreases their negative moods, and improves their interpersonal communication skills, according to a UM statement. Stress can affect the immune system in a way that impedes recovery from treatment for breast cancer.

Michael H. Antoni, PhD, director of UM’s Center for Psycho-Oncology Research, and colleagues developed the CBSM initiative to determine whether this intervention might counteract anxiety-related genetic alterations in people confronting a major medical threat. The participants included 199 women who were undergoing primary treatment of stage 0-III breast cancer. The women were randomized to the 10-week CBSM protocol or a control group.

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As Antoni’s group reported in Biological Psychiatry (2012;71[4]:366-372), the CBSM intervention was able to reverse anxiety-related effects on proinflammatory gene expression in circulating leukocytes. In the CBSM women, the genes that signal the production of type I interferon and other molecules associated with a healthy immune response were upregulated, or producing more of these substances, compared with women in the control group. At the same time, proinflammatory and metastasis-related genes were downregulated in the CBSM group.

“If stress affects the immune system in a negative way, then … recovery could be slowed down and those patients taking longer to recover may be at risk for poorer health outcomes,” explained Antoni in the UM statement. “Conversely, if stress-management intervention can reduce the impact of stress on the immune system, then recovery may be hastened.”