Sandra E. Sephton, PhD

Biological pathways of psychosocial effects in cancer progression. Research shows that tumor growth rates are determined partly by characteristics of the tumor and partly by characteristics of the host, including the cancer patient’s psychological adjustment, social environment, stress hormone levels, and immune function. The Biobehavioral Research Laboratory explores relationships between psychological stress, circadian function, and endocrine and immune factors relevant to tumor resistance. We have found that alteration of the diurnal rhythm of the stress hormone, cortisol, is prognostic for early breast cancer mortality. We are exploring circadian endocrine disruption as a potential mediator of stress effects on disease progression. We also are interested in stress and cortisol as mediators of the behavioral co-morbidities commonly experienced by cancer patients such as fatigue, depression, and sleep disturbances. We have found that social support, emotional expression, and spiritual or existential coping mechanisms appear protective of normal endocrine and immune function. Our current studies among patients with breast, lung, and gynecologic cancers suggest that endocrine abnormalities correlate with sleep/wake difficulties in breast cancer, circadian disruption predicts shortened lung cancer survival, and social support may protect against circadian disruption in gynecologic cancer.  This research is driven by a desire to understand stress-disease relationships in cancer, to define the factors that ameliorate effects of stress on disease and cancer co-morbidities, and to develop and test psychosocial interventions for cancer patients.