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abstract
BACKGROUND
The
impact of psychological well-being on the physiologic processes
involved in cancer progression remains unclear. Prior research has
implicated adrenergic signaling in tumor growth and metastasis. Given
that adrenergic signaling is influenced by both positive and negative
factors, the authors examined how 2 different aspects of well-being
(eudaimonic and positive affect) and psychological distress were
associated with tumor norepinephrine (NE) in patients with ovarian
cancer.
(definition: epinephrine and norepinephrine, also called adrenaline and noradrenaline, two separate but related hormones secreted by the medulla of the adrenal glands.)
(definition: epinephrine and norepinephrine, also called adrenaline and noradrenaline, two separate but related hormones secreted by the medulla of the adrenal glands.)
METHODS
A
total of 365 women with suspected ovarian cancer completed psychosocial
assessments before surgery and clinical information was obtained from
medical records.
Study inclusion was confirmed after histological diagnosis. Tumor NE was measured in frozen tissue samples using high-performance liquid chromatography with electrochemical detection. Confirmatory factor analysis was used to model eudaimonic (plain english = happiness) well-being, positive affect, and psychological distress, and structural equation modeling was used to examine associations between these factors and tumor NE.
Study inclusion was confirmed after histological diagnosis. Tumor NE was measured in frozen tissue samples using high-performance liquid chromatography with electrochemical detection. Confirmatory factor analysis was used to model eudaimonic (plain english = happiness) well-being, positive affect, and psychological distress, and structural equation modeling was used to examine associations between these factors and tumor NE.
RESULTS
Eudaimonic
well-being, positive affect, and psychological distress, modeled as
distinct but correlated constructs, best fit the data (ie, compared with
unitary or 2-factor models) (root mean square error of approximation,
0.048; comparative fit index, 0.982; and standardized root-mean-squared
residual, 0.035). Structural equation modeling analysis that included
physical well-being, stage of disease, histology, psychological
treatment history, beta-blocker use, and caffeine use as covariates was
found to have good model fit (root mean square error of approximation,
0.052; comparative fit index, 0.955; and standardized root-mean-squared
residual, 0.036) and demonstrated that eudaimonic well-being was related
to lower tumor NE (β = -.24 [P = .045]). In contrast, no effects were found for positive affect or psychological distress.
CONCLUSIONS
Eudaimonic
well-being was found to be associated with lower tumor NE, independent
of positive affect and psychological distress. Because adrenergic signaling is implicated in tumor progression, increasing eudaimonic
well-being may improve both psychological and physiologic resilience in
patients with ovarian cancer.
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