Recent research provides evidence that disrupted circadian rhythms, including hormonal patterns and sleep, are associated with increased risk of breast cancer incidence and faster progression to mortality. We have observed that loss of normal diurnal cortisol rhythm associated with more awakenings during the night predicts early mortality with metastatic breast cancer. Other recent studies have shown that nighttime shift work is associated with higher breast cancer incidence, and in a murine model disrupting circadian cortisol cycles produced a doubling of implanted tumor growth. There is also recent evidence that abnormal clock genes are associated with cancer. However, it is not clear whether sleep disruption per se affects breast cancer progression, or whether such an effect is mediated by hormonal and immune dysregulation of this prevalent and hormone-mediated cancer. We propose to study sleep disruption as a prognostic factor in the progression of metastatic breast cancer. We will also examine sleep patterns in association with disrupted circadian rhythms of cortisol, CRF, ACTH, and melatonin as well as measures of immune function known to be salient to breast cancer progression. These are natural killer cell cytotoxicity and specific cytokines: tumor necrosis factor alpha and nuclear factor kappa B. We plan to recruit 117 women 55 and older with metastatic breast cancer and 63 age and SES-matched controls for a two-week at home sleep study using Actiwatch and one night of in-home EEG monitoring, followed by 32 hours of EEG sleep monitoring and continuous blood sampling in the General Clinical Research Center. This will provide full circadian hormone assessment associated with thorough assessment of sleep patterns. We will relate these measures to the subsequent course of breast cancer progression. Results of this study will provide specific evidence regarding how improved sleep management may affect the course of breast cancer.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA118567-05
Application #
7898730
Study Section
Biobehavioral Mechanisms of Emotion, Stress and Health Study Section (MESH)
Program Officer
Mc Donald, Paige A
Project Start
2006-09-27
Project End
2012-07-31
Budget Start
2010-08-01
Budget End
2012-07-31
Support Year
5
Fiscal Year
2010
Total Cost
$424,598
Indirect Cost
Name
Stanford University
Department
Psychiatry
Type
Schools of Medicine
DUNS #
009214214
City
Stanford
State
CA
Country
United States
Zip Code
94305
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Zeitzer, Jamie M; Nouriani, Bita; Rissling, Michelle B et al. (2016) Aberrant nocturnal cortisol and disease progression in women with breast cancer. Breast Cancer Res Treat 158:43-50
Zeitzer, Jamie M; Nouriani, Bita; Neri, Eric et al. (2014) Correspondence of plasma and salivary cortisol patterns in women with breast cancer. Neuroendocrinology 100:153-61
Hahm, Bong-Jin; Jo, Booil; Dhabhar, Firdaus S et al. (2014) Bedtime misalignment and progression of breast cancer. Chronobiol Int 31:214-21
Palesh, Oxana; Aldridge-Gerry, Arianna; Zeitzer, Jamie M et al. (2014) Actigraphy-measured sleep disruption as a predictor of survival among women with advanced breast cancer. Sleep 37:837-42
Diaz, Michael; Aldridge-Gerry, Arianna; Spiegel, David (2014) Posttraumatic growth and diurnal cortisol slope among women with metastatic breast cancer. Psychoneuroendocrinology 44:83-7
Aldridge-Gerry, Arianna; Zeitzer, Jamie M; Palesh, Oxana G et al. (2013) Psychosocial correlates of sleep quality and architecture in women with metastatic breast cancer. Sleep Med 14:1178-86
Spiegel, David (2012) Mind matters in cancer survival. Psychooncology 21:588-93
Giese-Davis, Janine; Collie, Kate; Rancourt, Kate M S et al. (2011) Decrease in depression symptoms is associated with longer survival in patients with metastatic breast cancer: a secondary analysis. J Clin Oncol 29:413-20
Spiegel, David (2011) Mind matters in cancer survival. JAMA 305:502-3

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