The incidence and mortality rates for invasive cervical cancer in minority, low-income, and less educated women exceeds that for white, higher income, and better educated women. In southern California the incidence and mortality rates for cervical cancer are nearly twice that of non-Latina white women. Our preliminary work supports and extends the extant literature, noting that quality of life can be significantly disrupted among cervical cancer survivors, with qualitative differences in how Latina women experience cancer survivorship. However, there is a paucity of literature on interventions designed to assist cervical cancer survivors manage illness-specific stress and improve health behaviors. Our preliminary NCI-funded study provides strong data indicating that a six session psychosocial telephone counseling (PTC) intervention can improve QOL, with accompanying intervention-induced neuroendocrine and immune parameter modulations which may be related to disease endpoints. Specifically, we demonstrated a significant association between the improvement in QOL elicited by PTC and a shift to a more pronounced Th1 immunologic stance. In primary support of these significant biobehavioral findings, the project herein proposes to accomplish the following Specific Aims: 1) Test the efficacy of PTC for cervical cancer survivors, compared to usual care. 2) Evaluate the longitudinal immune and neuroendocrine parameters in cervical cancer patients who have received PTC, compared to usual care. 3) Examine the longitudinal relationship between PTC associated modulations of QOL measures and biologic parameters (immune and neuroendocrine). To achieve these aims we will randomize patients ascertained through the two SEER cancer registries to PTC (N=125) or usual care (N=125), stratifying on English or Spanish language preference. Assessments will occur at baseline (9-20 months post diagnosis), and three and nine months post enrollment/baseline. Assessments will include evaluation of QOL (overall QOL, psychological distress, coping, social support, sexual functioning), health behaviors, neuroendocrine parameters (DHEA-S, cortisol, GH) and immunologic parameters (NK cell activity, IL-5, interferon, HPV E6/E7 peptides, IL-15, IL 10). This project has significant public health relevance for an important unstudied cancer survivor population, many of whom are poor and underserved. If effective, an intervention which could improve quality of life (QOL) and health behaviors, and enhance neuroendocrine and immune responses for women with cervical cancer could have significant implications toward disease recurrence or survival.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA118136-04
Application #
7777850
Study Section
Biobehavioral Mechanisms of Emotion, Stress and Health Study Section (MESH)
Program Officer
Mc Donald, Paige A
Project Start
2007-03-19
Project End
2012-02-29
Budget Start
2010-03-01
Budget End
2011-02-28
Support Year
4
Fiscal Year
2010
Total Cost
$441,025
Indirect Cost
Name
University of California Irvine
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
046705849
City
Irvine
State
CA
Country
United States
Zip Code
92697
Pfaendler, Krista S; Wenzel, Lari; Mechanic, Mindy B et al. (2015) Cervical cancer survivorship: long-term quality of life and social support. Clin Ther 37:39-48
Biegler, Kelly A; Anderson, Amanda K L; Wenzel, Lari B et al. (2012) Longitudinal change in telomere length and the chronic stress response in a randomized pilot biobehavioral clinical study: implications for cancer prevention. Cancer Prev Res (Phila) 5:1173-82
Osann, Kathryn; Wenzel, Lari; Dogan, Aysun et al. (2011) Recruitment and retention results for a population-based cervical cancer biobehavioral clinical trial. Gynecol Oncol 121:558-64