Psychosocial telephone counseling for survivors of cervical cancer: results of a randomized biobehavioral trial.

Abstract

PURPOSE:

Survivors of cervical cancer experience quality-of-life (QOL) disruptions that persist years after treatment. This study examines the effect of a psychosocial telephone counseling (PTC) intervention on QOL domains and associations with biomarkers.

PATIENTS AND METHODS:

We conducted a randomized clinical trial in survivors of cervical cancer, who were ≥ 9 and less than 30 months from diagnosis (n = 204), to compare PTC to usual care (UC). PTC included five weekly sessions and a 1-month booster. Patient-reported outcomes (PROs) and biospecimens were collected at baseline and 4 and 9 months after enrollment. Changes in PROs over time and associations with longitudinal change in cytokines as categorical variables were analyzed using multivariable analysis of variance for repeated measures.

RESULTS:

Participant mean age was 43 years; 40% of women were Hispanic, and 51% were non-Hispanic white. Adjusting for age and baseline scores, participants receiving PTC had significantly improved depression and improved gynecologic and cancer-specific concerns at 4 months compared with UC participants (all P < .05); significant differences in gynecologic and cancer-specific concerns (P < .05) were sustained at 9 months. Longitudinal change in overall QOL and anxiety did not reach statistical significance. Participants with decreasing interleukin (IL) -4, IL-5, IL-10, and IL-13 had significantly greater improvement in QOL than those with increasing cytokine levels.

CONCLUSION:

This trial confirms that PTC benefits mood and QOL cancer-specific and gynecologic concerns for a multiethnic underserved population of survivors of cancer. The improvement in PROs with decreases in T-helper type 2 and counter-regulatory cytokines supports a potential biobehavioral pathway relevant to cancer survivorship.

• Authors: Lari Wenzel, Kathryn Osann, Susie Hsieh, Jo A Tucker, Bradley J Monk, Edward L Nelson
• Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 33 Issue 10 Pg. 1171-9 (Apr 01 2015) ISSN: 1527-7755 [Electronic] United States
• PMID: 25713429 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
• Copyright: © 2015 by American Society of Clinical Oncology.

Chemical References

• Cytokines

Topics

• Adaptation, Psychological
• Adult
• Anxiety (diagnosis, psychology)
• Counseling (methods)
• Cytokines (blood)
• Depression (diagnosis, psychology)
• Female
• Follow-Up Studies
• Hispanic or Latino (statistics & numerical data)
• Humans
• Middle Aged
• Quality of Life
• Social Support
• Stress, Psychological (diagnosis, psychology)
• Surveys and Questionnaires
• Survivors (psychology)
• Telephone
• Th2 Cells (metabolism)
• Treatment Outcome
• Uterine Cervical Neoplasms (ethnology, psychology, therapy)
• White People (statistics & numerical data)