Stress Management for Cancer Patients - Dr. Antoni

Stress Management for Patients Undergoing Treatment: Effects, Biobehavioral Mechanisms, and Next Steps in Research WellBeingWell April 26, 2011 Miami, FL ,[object Object],[object Object],[object Object],[object Object],NCI 84944-P50 M. Antoni, P.I. NCI 064710-R01 M. Antoni, P.I.

Empirical Support for the Mind-Body Connection: The Case of Stress Management ,[object Object],[object Object],[object Object],[object Object]

Family of Stress Management Studies at UM (1986-2011) TELE CBSM TELE- CBSM Community-based CBSM HIV MSM Hetero Men Inner-City Women Asymp Dx Notif Symp Pre-HAART HAART Asymp. HIV+ AIDS HAART Eng Lang Spa Lang Spa Lang Eng Lang HPV + SIL Post- Adj Stage I-IIla BRCA Pre- Adj Stage I-II Stage I-IIIa Dismantle CBSM Abbrev CBSM PRCA Post Surg Post Radiation Advanced Disease Eng Lang Spa Lang Eng Lang Spa Lang Eng Lang CFS SMART ENERGY

A CASE FOR STRESS MANAGEMENT: Does Cognitive Behavioral Stress Mgmt (CBSM) affect psychosocial, neuroendocrine and immune functioning? ,[object Object],[object Object],[object Object],[object Object]

Theory Testing in Biobehavioral Oncology Across the Cancer Continuum Prevention Detection Diagnosis & Treatment Early Survivorship Late Efects Longer-term Survivorship Cancer Continuum Target Populations Patients/ Survivors Family Community Methodology Observational Assessment Randomized Controlled Trials Community-Participatory PREDICTORS Person Factors Socio-cultural Factors QOL /HEALTH OUTCOMES Behavioral Psychological Physical MEDIATORS Behavioral Processes Biological Processes

How Are Psychological Processes Related to Cancer Adaptation and Health Outcomes? ,[object Object],[object Object],[object Object]

E.g., Stress Management for Women with Breast Cancer ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

CBSM Breast Cancer Studies at U.Miami (1992-2011) Community-Based Post- Adj Stage I-IIla BRCA Pre- Adj Stage I-II Stage I-IIIa Dismantle CBSM Abbrev CBSM

CBSM ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object], Physical Health  QOL Normalize endocrine and immune regulation ,[object Object],[object Object],[object Object],[object Object],Theoretical Model for Using Cognitive Behavioral Stress Management during Cancer Treatment Antoni, M.H. (2003) Stress Management Intervention for Women with Breast Cancer . Washington DC: APA Press.

What is involved in Stress Management? ,[object Object],[object Object],[object Object],[object Object]

Anger Management Social Support Assertiveness Stress Response Cognitive Restructuring (challenging thoughts) YES NO Automatic Thought Cognitive Emotion Focused Softening (If still distressed) Coping Social Physical Behavioral Emotional Distorted? Problem Focused Uncontrollable Controllable ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Stressful Event Antoni, Ironson, Schneiderman 2007

Week Relaxation Stress Management 1 PMR 7 Stress & Awareness 2 PMR 4/D.B. Stress & Awareness/Stress Appraisals 3 D.B./PMR Disease-Specific , Automatic Thoughts 4 Autogenics Auto. Thghts, Distortions, Thght Rep. 5 D.B./Visualiz. Cognitive Restructuring 6 Sunlight Med. Effective Coping I 7 Color Meditation Effective Coping II 8 Meditation Social Support 9 Mindfulness Anger Management 10 Part. Choice Assertion Training & Program Review Topics of CBSM (Antoni et al., 2003, 2007; Penedo et al., 2008)

Assessment Time Points T1 surgery T4 One year post surgery T3 T2 2-8 wks post B SMART-10 wks. 3 months post 6 months post

CBSM Intervention after Surgery for Breast Cancer: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

1980s 1990s 2000- Study 1: Psychosocial processes in adaptation to breast cancer treatment History of BREAST CANCER RESEARCH Study 2: CBSM Effects on Psy Adaptation to Breast cancer treatment ,[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object], Angiogenesis / Pro-angiogenic cytokines (VEGF, IL-6) ACTH Cortisol NE/Epi CRF / Locus Coeruleus  Dopamine  Oxytocin Oncogenic viruses ,[object Object],[object Object],[object Object],[object Object],[object Object],Optimism Perceived Stress Depression External Events Psychological Reactions Neuroendocrine Activity Peripheral Tissue Antoni et al. (2006). Nature Reviews Cancer, 6, 240-248. Adrenal Gland Cancer cells Immune cells (will need to show different types of cells – NK, T, Macroph, etc.) Endothelial cells (or a blood vessel) Social Isolation Negative Life Events Environmental stressors (SES)

Does CBSM also affect cellular immunity in Women with BCa? ,[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object]

CBSM Intervention after Surgery for Breast Cancer: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Examining Biobehavioral Processes Associated with CBSM in Cancers ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Biobehavioral Pathways Associated with Stress and Cancer Pathogenesis (Miller & Cole, 2009 Ann Rev Psychol .) CREB/ATF GR NFkB/ IL-1 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Type I IFN

What about changes in Gang Activity? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Examining Leukocyte Transcription Changes after CBSM in BCa ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Lutgendorf, Sood & Antoni, J. Clin Onc , 2010 Tracking Gene Gangs in the Hood………

Other Areas of Current Interest ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Can Stress Management Intervention Facilitate Positive Adjustment after Adjuvant Therapy for Breast Cancer has ended? NCI grant P50CA84944. M. Antoni, P.I. Examining the effects of CBSM at 3 - 12 months after adjuvant therapy has been completed

Ongoing Work In CBSM ,[object Object],[object Object],[object Object],[object Object],[object Object]

5wk RT vs 5wk CBT vs 5wk Educ grp grp grp ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Delivering CBSM in the Community: Project CARE (Lechner, P.I., Antoni, co-PI, Kobetz, co-PI) NCI R01CA131451 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Hey what about the men? CBSM Prostate Cancer Studies at U.Miami (2000-2011) Tele-Phone CBSM PRCA Post Surg Post Radiation Advanced Disease Eng Lang Spa Lang Eng Lang Spa Lang Eng Lang

CBSM and Prostate Cancer (Penedo, Schneiderman, Antoni-NCI-P50) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Stress Reduction Materials for Persons with Cancer Antoni, M.H. (2003) Stress Management Intervention for Women with Breast Cancer . Washington DC: APA Press. Penedo, F., Antoni, M.H. & Schneiderman, N. (2008) Cognitive-Behavioral Stress Management for Prostate Cancer Recovery. N.Y.: Oxford Press.

Can You Hear Me Now?: Can CBSM groups be Delivered Over the Phone? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Developing and Testing Psychosocial Interventions in Clinical Disease: “Drilling Down and Reaching Out” ,[object Object],[object Object],[object Object]

Acknowledgments NCI (R01 CA64710/ P50CA84944/ R01CA131451) NIMH (P01 NIMH49548) NINDS (1R01NS072599-01; 1R01 NS055672-01) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Stress Management for Cancer Patients - Dr. Antoni

Recomendados

Recomendados

Mais conteúdo relacionado

Mais procurados

Mais procurados (20)

Semelhante a Stress Management for Cancer Patients - Dr. Antoni

Semelhante a Stress Management for Cancer Patients - Dr. Antoni (20)

Mais de Sylvester Comprehensive Cancer Center

Mais de Sylvester Comprehensive Cancer Center (18)

Último

Último (20)

Stress Management for Cancer Patients - Dr. Antoni