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Interleukin-6 and use of social support in gynecologic cancer patients

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Abstract

Interleukin-6 (IL-6) is related to disease progression in ovarian and cervical cancers and is associated with abnormal endometrial cell growth. IL-6 is also involved in the stress response and depression. We examined relationships among distress, use of social support, IL-6, clinical status, and disability in gynecologic cancer patients. A sample of 21 gynecologic cancer patients with early stage or regionally advanced disease who had not yet received initial treatment and 33 healthy controls completed psychosocial assessments and had early morning blood draws. This was done presurgery for patients. Clinical and functional status of patients was assessed at 1 year. IL-6 was significantly higher among patients than among controls. Among patients, seeking instrumental support at diagnosis was associated with lower concurrent IL-6, better clinical status, and less disability at 1 year. Distress was not correlated with these outcome measures, and IL-6 did not mediate the effects of social support on these outcomes. These findings suggest that the ways patients cope with stress of cancer may be associated with a cytokine that is involved in tumor progression in gynecologic cancers and with clinical variables at 1 year.

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References

  • Aiken, L.S., & West, S.G. (1991). Multiple regression: Testing and interpreting interactions. Newbury Park, CA: Sage.

    Google Scholar 

  • American Cancer Society. (1999). Cancer facts and figures—1999. Atlanta, GA: Author.

    Google Scholar 

  • Andersen, B., Anderson, B., & de Prosse, C. (1989). Controlled prospective longitudinal study of women with cancer: II. Psychological Outcomes. Journal of Consulting and Clinical Psychology, 57, 692–697.

    Article  PubMed  Google Scholar 

  • Andersen, B. L., Farrar, W. B., Golden-Kreutz, D., Kutz, L. A., MacCallum, R., Courtney, M.E. & Glaser, R. (1998). Stress and immune responses after surgical treatment for regional breast cancer. Journal of the National Cancer Institute, 90, 30–36.

    Article  PubMed  Google Scholar 

  • Andersen, B., Kiecolt-Glaser, J., & Glaser, R. (1994). A biobehavioral model of cancer stress and disease course. American Psychologist, 49, 389–404.

    Article  PubMed  Google Scholar 

  • Baron, R., Cutrona, C, Russell, D., & Lubaroff, D. (1990). Social support and immune function among spouses of cancer patients. Journal of Personality and Social Psychology, 39, 344–352.

    Article  Google Scholar 

  • Baron, R.M., & Kenney, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.

    Article  PubMed  Google Scholar 

  • Berek, J. S., Chung, C, Kaldi, K., Watson, H. M., Knox, R. M., & Martinez-Maza, O. (1991). Serum interleukin-6 levels correlate with disease status in patients with epithelial ovarian cancer. American Journal of Obstetrics & Gynecology, 164, 1038–1042.

    Google Scholar 

  • Berman, W. H., & Turk, D. C. (1981). Adaptation to divorce: Problems and coping strategies. Journal of Marriage & the Family, 43, 179–189.

    Article  Google Scholar 

  • Billings, A. G., & Moos, R. H. (1984). Coping, stress, and social resources among adults with unipolar depression. Journal of Personality & Social Psychology, 46, 877–891.

    Article  Google Scholar 

  • Carver, C., Sheier, M., & Weintraub, J. (1989). Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology, 56, 267–283.

    Article  PubMed  Google Scholar 

  • Chopra, V., Dinh, T. V., & Hannigan, E. V. (1997). Serum levels of interleukins, growth factors and angiotensin in patients with endometrial cancer. Journal of Cancer Research and Clinical Oncology, 123, 167–172.

    PubMed  Google Scholar 

  • Chopra, V., Dinh, T. V., & Hannigan, E. (1998). Circulating serum levels of cytokines and angiogenic factors in patients with cervical cancer. Cancer Investigation, 16, 152–159.

    Article  PubMed  Google Scholar 

  • Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98, 310–357.

    Article  PubMed  Google Scholar 

  • Corney, R. H., Everett, H., Howells, A., & Crowther, M. E. (1992). Psychological adjustment following major gynaecological surgery for carcinoma on the cervix and vulva. Journal of Psychosomatic Research, 36, 561–568.

    Article  PubMed  Google Scholar 

  • Costanza, R. S., Derlega, V. J., & Winstead, B. A. (1988). Positive and negative forms of social support: Effects of conversational topics on coping with stress among same-sex friends. Journal of Experimental Social Psychology, 24, 182–193.

    Article  Google Scholar 

  • Curran, S. L., Andrykowski, M. A., & Studts, J. L. (1995). Short form of the profile of mood states (POMS-SF): Psychometric information. Psychological Assessment, 7, 80–83.

    Article  Google Scholar 

  • DeRijk, R., Michelson, D., Karp, B., Petrides, J., Galliven E., Deuster, P., Paciotti, G., Gold, P.W., & Sternberg, E.M. (1997). Exercise and circadian rhythm-induced variations in plasma cortisol differentially regulate interleukin-1b (IL-1b), Il-6, and tumor necrosis factor (TNF-a) production in humans: High sensitivity of TNFa and resistance of IL-6. Journal of Clinical Endocrinology Metabolism, 82, 1–10.

    Article  Google Scholar 

  • Ershler, W. B. (1993). Interleukin-6: A cytokine for gerontologists. Journal of the American Geriatric Society, 41, 176–181.

    Google Scholar 

  • Eustace, D., Han, X., Gooding, R., Rowbottom, A., Riches, P., & Heyderman, E. (1993). Interleukin-6 (IL-6) functions as an autocrine growth factor in cervical carcinomas in vitro. Gynecologic Oncology, 50, 15–19.

    Article  PubMed  Google Scholar 

  • Frankenhaeuser, M. (1991). The psychophysiology of workload, stress and health: Comparison between the sexes. Annals of Behavioral Medicine, 13, 197–204.

    Google Scholar 

  • Frommberger, U. H., Bauer, J., Haselbauer, P., Fraulin, A., Riemann, D., & Berger M. (1997). Interleukin-6 (IL-6) plasma levels in depression and schizophrenia: comparison between the acute state and after remission. European Archives of Psychiatry & Clinical Neuroscience, 247, 228–33.

    Article  Google Scholar 

  • Funch, D. P., & Mettlin, C. (1982). The role of support in relation to recovery from breast surgery. Social Science and Medicine, 16, 19–98.

    Article  Google Scholar 

  • Helgeson, V. S., & Cohen, S. (1996). Social support and adjustment to cancer: Reconciling descriptive, correlational, and intervention research. Health Psychology, 15, 135–148.

    Article  PubMed  Google Scholar 

  • Herbert, T. B., & Cohen, S. (1993). Depression and immunity: a meta-analytic review. Psychology Bulletin, 113, 472–486.

    Article  Google Scholar 

  • House, J. S., & Kahn, R.L. (1985). Measures and concepts of social support. In S. Cohen & L. Syme (Eds.), Social support and health (pp.83–108).Orlando, FL: Academic.

    Google Scholar 

  • House, J. S., Landis, K. R., & Umberson, D. (1988). Social relationships and health. Science, 241, 540–545.

    Article  PubMed  Google Scholar 

  • Kiecolt-Glaser, J. K., Malarkey, W. B., Chee, M., Newton, T., Cacioppo, J. T., Mao, H., & Glaser, R. (1993). Negative behavior during marital conflict is associated with immunological down-regulation. Psychosomatic Medicine, 55, 395–409.

    PubMed  Google Scholar 

  • Kuhn, C. (1989). Adrenocortical and gonadal steroids in behavioral cardiovascular medicine. In N. Schneiderman, S. Weiss, & P. Kaufmann (Eds.), Handbook of research methods in cardiovascular behavioral medicine (pp. 185–204). New York: Plenum.

    Google Scholar 

  • Lepore, S. J., Allen, K. A., & Evans, G. W. (1993). Social support lowers cardiovascular reactivity to an acute stressor. Psychosomatic Medicine, 55, 518–524.

    PubMed  Google Scholar 

  • Levy, S. M., Heberman, R. B., Lee, J., Whiteside, T., Kirkwood, J., &McFeeley, S. (1990). Estrogen receptor concentration and social factors as predictors of natural killer cell activity in early-stage breast cancer patients: Confirmation of a model. Natural Immunity and Cell Growth Regulation, 313–324.

  • Lutgendorf, S. K., Garand, L., Buckwalter, K, C., Tripp Reimer, T., Hong, S-Y., & Lubaroff, D. (1999). Life stress, mood disturbance, and elevated interleukin-6 in healthy older women. Journals of Gerontology: Medical Sciences, 54A, M1-M6.

    Google Scholar 

  • Maes, M., Bosnians, E., De Jongh, R., Kenis, G., Vandoolaeghe, E., & Neels, H. (1997). Increased serum IL-6 and IL-1 receptor antagonist concentrations in major depression and treatment resistant depression. Cytoldne, 9, 853–858.

    Google Scholar 

  • Mastorakos, G., Chrousos, G. P., & Weber, J. S. (1993). Recombinant Interleukin-6 activates the hypo-thalamic pituitary adrenal axis in humans. Journal of Clinical Endocrinology Metabolism, 77, 1690–1694.

    Article  PubMed  Google Scholar 

  • Mitchell, G. W., & Glicksman, A. S. (1977). Cancer patients: Knowledge and attitudes. Cancer, 40, 61–66.

    Article  PubMed  Google Scholar 

  • Neises, M., Nebe, T., Schiller, A., Ditz, S., Wischnik, A., & Melchert, F. (1995). Coping with illness/quality of life and immunologic parameters of patients with breast carcinoma and benign tumors. Gynäkologisch-Geburtshilfliche Rundschau, 35(Suppl. 1), 166–171.

    Article  PubMed  Google Scholar 

  • Obata, N. H., Tamakoshi, K., Shibata, K., Kikkawa, F., & Tomoda, Y. (1997). Effects of interleukin-6 on in vitro cell attachment, migration, and invasion of human ovarian carcinoma. Anticancer Research, 17, 337–342.

    PubMed  Google Scholar 

  • Peck, A., & Bowland, J. (1977). Emotional reactions to radiation treatment. Cancer, 40, 180–184.

    Article  PubMed  Google Scholar 

  • Plante, M., Rubin, S. C., Wong, G. Y., Federici, M. G., Finstad, C. L., & gastl, G. A. (1994). Interleukin-6 level in serem and ascites as a prognostic factor in patients with epithehal ovarian cancer. Cancer, 73, 1882–1888.

    Article  PubMed  Google Scholar 

  • Reynaert, C., Janne, P., Bosly, A., Staquet, P., Zdanowicz, N., Vause, M., Chatelain, B., & Lejeune, D. (1995). From health locus of control to immune control: Internal locus of control has a buffering effect on natural killer cell activity decrease in major depression. Acta Psychiatrica Scandinavica, 92, 294–300.

    Article  PubMed  Google Scholar 

  • Salaffi, F., Cavalieri, F., Nolli, M., & Ferraccioli, G. (1991). Analysis of disability in knee osteoarthritis: Relationship with age and psychological variables but not radiographic score. Journal of Rheumatology, 18, 1581–1586.

    PubMed  Google Scholar 

  • Scambia, G., Testa, U., Benedetti, P., Foti, E., Nartucci, R., Gadducci, A., Perillo, A., Facchini, V., Peschle, C., & Mancuso, S. (1995). Prognostic significance of IL-6 serum levels in patients with ovarian cancer. British Journal of Cancer, 71, 352–356.

    Google Scholar 

  • Seeman, T. E., Berkman, L. F., Blazer, D., & Rowe, J. W. (1994). Social ties and support and neuroendocrine function: The MacArthur studies of successful aging. Annals of Behavioral Medicine, 16, 95–106.

    Google Scholar 

  • Shacham, S. (1983). A shorterned version of the Profile of Mood States. Journal of Personality Assessment, 47, 305–306.

    Article  PubMed  Google Scholar 

  • Sluzewska, A., Rybakowski, J., Laciak, M., Mackiewicz, A., Sobieska, M., & Wiktorowicz, K. (1995). Interleukin-6 levels in depressed patients before and after treatment with fluoxetine. Annals the New York Academy of Sciences, 762, 474–476.

    Article  Google Scholar 

  • Uchino, B. N, Cacioppo, J. T., & Kiecolt-Glaser, J. K. (1996). The relationship between social support and physiological processes: A review with emphasis on underlying mechanisms and implications for health. Psychological Bulletin, 119, 488–531.

    Article  PubMed  Google Scholar 

  • van Gool, J., van Vugt, Ft., Helle, M. & Aarden, L. A. (1990). The relation among stress, adrenalin, interleukin-6 and acute phase proteins in the rat. Clinical Immunology and Immunopathology, 57, 200–210.

    Article  PubMed  Google Scholar 

  • Van Snick, J. (1990). Interleukin-6: An overview. Annual Review of Immunology, 8, 253–278.

    Article  PubMed  Google Scholar 

  • Zarmakoupis, P. N., Rier, S. E., Maroulis, G. B., & Becker, J. L. (1995). Inhibition of human endometrial stromal cell proliferation by interleukin-6. Human Reproduction, 10, 2395–9.

    PubMed  Google Scholar 

  • Zhou, D., Kusnecov, A., Shurin, M., DePaoli, M., & Rabin, B. (1993). Exposure to physical and psychological stressors elevates plasma interleukin-6. Relationship to the activation of hypothalamic-pitu-itary-adrenal axis. Endocrinology, 133, 2523–2530.

    Article  PubMed  Google Scholar 

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Correspondence to Susan K. Lutgendorf.

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This work was partially supported by American Cancer Society Institutional Seed Grant IN-122Q to the University of Iowa and Grant RR00059 from the GCRCNCRR NIH to the CRC at the University of Iowa.

We are grateful to Charles Davis and Jane Leserman for statistical consultation; Sharon Krogman, Karin Larsen, and Betsy Brandl for assistance with data collection; and Sue-Young Hong for laboratory assistance.

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Lutgendorf, S.K., Anderson, B., Sorosky, J.I. et al. Interleukin-6 and use of social support in gynecologic cancer patients. Int. J. Behav. Med 7, 127–142 (2000). https://doi.org/10.1207/S15327558IJBM0702_3

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