not experiencing distress. For this reason it is important to take multiple measures of stress (self-report, other-report, and physiological), as well as measures of personality and coping behaviors, to determine if patients are prone to suppressing emotions. The role of the immune system and specific immune indices in mediating the effects of stress on breast cancer progression also needs to be examined in greater detail. Although the link between stress and immune changes has been shown repeatedly, the link between stress-related immune activity and disease has not been consistently found, and mediational analyses are needed to determine if stress does affect breast cancer progression through its influence on immune cells.
Finally, although initial findings appear very promising, the efficacy of stress-reducing interventions is still untested and the understanding of mechanisms indulging their effects is still poor. Replication of studies finding less recurrence and lower mortality in patients undergoing interventions and verification of theoretically predicted moderators are necessary before endorsing these interventions. It is unknown what type of patient is most likely to benefit from interventions, whether the effectiveness of these interventions differs depending on patient's stage of disease, and what qualities of the interventions are most beneficial (i.e., content, frequency, and/or length of intevention). However, they provide a plausible and attractive mechanism explaining some of the effects of stress on cancer. Future intervention studies need to address these questions to determine the most effective and economical way to treat breast cancer patients.
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Publication information: Book title: Handbook of Health Psychology. Contributors: Andrew Baum - Author, Tracey A. Revenson - Author, Jerome E. Singer - Author. Publisher: Lawrence Erlbaum Associates. Place of publication: Mahwah, NJ. Publication year: 2001. Page number: 754.
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