VCU School of Nursing receives $3 million NIH grant to investigate stress management in breast cancer patients

By Michael Ford
University News Services

RICHMOND, Va. (Dec. 2, 2004) – The National Institutes of Health has awarded the Virginia Commonwealth University School of Nursing a $3 million grant to research whether stress-management techniques can improve immune system responses in women with breast cancer.

The five-year study will enroll 240 women receiving chemotherapy for breast cancer. The research will evaluate whether complementary strategies for stress management can ease psychological distress, positively affect physical symptoms and enhance immune function in breast-cancer patients. These “mind-body-spirit” interventions will be evaluated using multiple biological markers to shed light on a study participant’s health status over time.

Nancy L. McCain, R.N., D.S.N., the principal investigator, will test whether two complementary approaches -- tai chi training and spiritual-growth groups -- can reduce perceived stress and enhance coping strategies. Tai chi is described as meditation in motion that focuses on slow, graceful movements to increase strength and flexibility and to improve balance and circulation. Both of the approaches should normalize levels of stress-related hormones like cortisol and endorphins, she said.

“Psychological stress and physical stress generate a series of hormonal and biochemical interactions in the body that can influence health,” said McCain, professor in adult health nursing and an expert in psychoneuroimmunology, the study of mind-body-spirit interactions.

“We cannot completely eliminate stress from a person’s life, but by employing a variety of complementary “mind-body” interventions, positive changes in the neuroendocrine-immune system should follow.”

Cortisol, often called the stress hormone, is produced by the adrenal glands. The levels of cortisol increase in response to any stress in the body, whether psychological or physical, such as illness, trauma or temperature extremes. Endorphins are among the brain chemicals known as neurotransmitters. Stress and pain are among the most common stimulators of endorphin release. Endorphin secretion results in reduced pain perception, feelings of euphoria and increased immune response.

“As we gain greater understanding of immunocompetence, behavioral triggers and the integrated hormonal and biochemical functions of the body, there is great potential for lessening the physical and psychological symptoms associated with diseases such as breast cancer,” McCain said.

Co-investigators on the project, from the VCU School of Nursing, are Patricia Gray, Ph.D., associate professor and chair of adult health nursing; Inez Tuck, Ph.D., professor and chair of integrative systems; R.K. Elswick, Jr., Ph.D., associate professor of biostatistics and nursing; Sadeeka Al-Majid, Ph.D., and Jo Robins, Ph.D., adult health nursing; Gayle Roux, Ph.D., maternal-child nursing; and Jeanne Walter, Ph.D. candidate. Additional co-investigators from the VCU School of Medicine are Harry D. Bear, M.D., professor and division chair, surgical oncology; and Thomas J. Smith, M.D., professor and division chair, hematology/oncology. McCain, Bear and Smith are also members of VCU’s Massey Cancer Center, the primary recruitment site for study participants.

One of 84 comprehensive nursing schools in the country, the VCU School of Nursing is ranked 48th among America’s best graduate schools by U.S. News & World Report and recently ranked 25th among nursing schools in NIH-funded research.

The National Cancer Institute, which funded the grant, is one of the 27 institutes and centers that make up the National Institutes of Health. NCI is the federal government’s principal agency for cancer research and training.