Stress, social support, immune response, and fatigue in women with breast cancer

Breast cancer is the most common type of cancer in women, with over 1 million new cases reported in the world each year. The diagnosis and treatment of breast cancer causes intense psychological and emotional stress. Perceived stress, in turn, has been shown to have a deleterious effect on a wide array of immune responses including natural killer cell (NK) activity, interferon gamma (IFN-γ), and Interleukin-2 (IL-2) production, and potentially on cancer-related fatigue. Social support, on the other hand, has been shown to increase immune responses and positively impact health via direct (main effect) and indirect (stress-buffering effect) mechanisms. Although social support has been studied extensively, little attention has been paid to the specific type and source of social support most desired by patients or the role that type and source of and perceived satisfaction with social support has on stress, immune responses, and fatigue during the early critical phases of cancer diagnosis and treatment of women with breast cancer. Therefore, the purpose of this study was to examine the type and source of and satisfaction with social support over time and to examine the main and stress-buffering effects on NK activity, IFN-γ and IL-2 production and fatigue. A convenience sample of 57 women over the age of 19 years with newly diagnosed breast cancer was recruited from the University of Alabama at Birmingham, Interdisciplinary Breast Health Center. Based on the findings of this study, emotional support, aid, and total network support decreased significantly for women over the early course of their breast cancer diagnosis and treatment, although perceived satisfaction with social support did not significantly change. In addition, the amount of emotional support and aid varied depending on the specific source of support (spouse, family, and friend) and this perceived social support had a differential impact on immune responses and fatigue in women with breast cancer at various times in the disease trajectory. The implications of these results and directions for ongoing research in this area were discussed.