This ADAMHA RSA is requested to enable William H. Redd, Ph.D. , to pursue on a full-time basis his research on the behavioral effects of cancer treatment. The major thrust of proposed research is the examination of the impact of psychological factors on immune function in women receiving cycles of adjuvant chemotherapy for breast cancer. Of primary interest is the possibility that these patients develop classically conditioned immunosuppression. During cycles of chemotherapy, as many as 60% of patients have been reported to develop anticipatory nausea/vomiting such that cues associated with treatment elicit nausea/vomiting. Do patients develop analogous anticipatory immunosuppression? If so, what roles do psychological, biological and conditioning factors play? Three complement- ary studies are proposed. Study 1 investigates aspects of the natural course of psychological and immunological responses associated with chemotherapy that are critical to the subsequent studies. Study 2 is a longitudinal/prospective analysis of psychological and immunological changes associated with the anticipation of chemotherapy treatments. Study 3 involves the experimental analysis of possible classical conditioning of immune changes with chemotherapy by assessing patients' responses to previously neutral stimuli paired with chemotherapy administration.
The specific aims are: 1) To determine whether cyclic chemotherapy induces anticipatory immune suppression in addition to anticipatory nausea in these patients. 2) To investigate psychological, behavioral and biological factors that may influence the course of development of anticipatory immune suppression. 3) To explore the possibility that patients can be classically conditioned by the repeated pairing of explicit stimuli with chemotherapy infusions such that re-exposure to those stimuli, even after termination of all chemotherapy, induces immune suppression and/or nausea.
