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Cancer Control Research

Abstract

DESCRIPTION (provided by applicant): Endometrial cancer is the most common gynecologic cancer in the U.S. and the 2nd most deadly gynecologic cancer after ovarian cancer. Although there is an emerging body of research examining psychoneuroimmunologic (PNI) relations in breast and ovarian cancers, no research to our knowledge has examined these relations in endometrial cancer. Furthermore, few studies have examined PNI relations among cancer patients undergoing surgery - a period marked by high psychological and physical stress and high vulnerability to the establishment of metastases. Our long range goal is to improve the health and well- being of women with endometrial cancer. The objective of this application is to assess relations among life stress, diurnal salivary cortisol rhythm (a predictor of disease severity and mortality among cancer patients), and vascular endothelial growth factor (VEGF) (the most potent growth factor to promote tumor angiogenesis, the process by which new blood vessels are formed to supply tumor cells with nutrients and oxygen) among women undergoing endometrial cancer surgery. The central hypothesis of this application is that high life stress will be associated with more abnormal cortisol rhythms and higher VEGF levels during the perioperative period, and that relational health/social support will buffer these relations. This central hypothesis will be tested by pursuing the following specific aims in a sample of newly diagnosed endometrial cancer patients undergoing surgical removal of the uterus, ovaries, and fallopian tubes: (Aim 1) to identify relations among life stress, relational health, and salivary cortisol rhythm, and (Aim 2) to identify relations among life stress, relational health, and VEGF. If our hypothesized relations emerge, it will guide future research examining the extent to which these relations predict clinical outcomes and mortality in endometrial cancer. Our multidisciplinary research group is particularly well-prepared to pursue the proposed work due to our combined experience in biobehavioral and immunopathology research. The proposed study is innovative, because it will be among the first to examine biobehavioral relations among women undergoing cancer surgery. Finally, these results will be significant to public health initiatives, because although endometrial cancer is the 4th most common cancer and 8th leading cause of cancer related death among women, there is a paucity of research examining potential biobehavioral mechanisms of this disease.