For
years, physicians have said that a positive outlook on life can help patients of serious
diseases live longer. According to a
preliminary study published in the Journal of the
National Cancer Institute, researchers have now discovered a biological marker for
stress in advanced breast cancer patients that may help
predict their survival. Patients who have
abnormal levels of a steroid-like compound called cortisol in their saliva may be more
likely to die from breast cancer than patients with normal cortisol levels, according to
the study. Cortisol is a hormone that is
released in response to stress.
Researchers studied cortisol levels of
104 women with advanced breast cancer over a three-day period. Normally, cortisol levels follow a pattern or
“slope:” in the morning, cortisol levels reach their peak and drop as the day
progresses. In the study, the researchers
found that the majority of women who had abnormal “slopes” of cortisol levels
(which they called a “flattened slope”) did not live as long as the women with
normal cortisol levels.
The researchers also found lower counts
and suppressed activity of natural killer cells among the advanced breast cancer patients
with abnormal cortisol levels. Natural killer
cells help the immune system destroy threatening cells, including cancer cells. Women who have fewer or less active natural killer
cells may experience a more rapid progression of breast cancer.
Though the research is preliminary and
needs to be confirmed in larger clinical trials,
other studies have also suggested that the emotional well-being of advanced (metastatic)
breast cancer patients may influence survival. In
a study published in the May-June 2000 issue of the journal, Psychosom, researchers found that “a greater
quality of social support is associated with lower cortisol concentrations in women with
metastatic breast cancer, which is indicative of healthier neuroendocrine
functioning.” Thus, women who are
supported and comforted during breast cancer treatment may fare better.
Treatment advances are also helping to
extend the survival time of women with advanced breast cancer. Many advanced breast cancer patients are eligible
to participate in clinical trials which test the effectiveness of new treatments. Physicians encourage women with breast cancer to
seek support from family and friends and also consider other means of support if needed (i.e., cancer support groups).
Advanced breast cancer (Stage
IV/metastatic) is defined as breast cancer that has spread past the breast and axillary
(underarm) lymph nodes to other regions of the body (such
as the bone, liver, lung, or brain). The
National Cancer Institute estimates that approximately 10% to 20% of women with metastatic
breast cancer survive the disease (achieve permanent remission). Breast self-exam,
physician performed clinical breast exam, and screening mammography can help detect breast cancer early,
when the chances for minimally invasive treatment and survival are the greatest.
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