This article reviews the literature on psychoneuroimmunology and its theoretical underpinnings. It also reviews research related to the immune-system-link of stress, chronic stress, depression and health behaviors to breast cancer. Although the relationship between psychological characteristics and the immune system have been documented repeatedly, the significance of these effects has not been demonstrated in many studies empirically. The question whether the use of alternative therapies contributes to decreasing the progression of the diseased is often asked. Research in the area of psychoneuroimmunology can provide the answer to this question.
Get full access to this article
View all access options for this article.
References
1.
American Cancer Society (1997). Cancer facts and figures-1997. Atlanta, GA: Author.
2.
Andersen, B. L., Kiecolt-Glaser, J. K., & Glaser, R. ( 1994). A Biobehavioral Model of Cancer Stress and Disease Course . American Psychologist, 49, 389-404.
3.
Anisman, H., Irwin, J., & Sklar, L. (1989). The influence of stressors on the progression of neoplastic change. In W. Weisburger (Ed.), Mechanisms of Carcinogenesis (pp. 7-18).
4.
Bahnson, C. (1981). Stress and cancer: The state of the art. Psychosomatics, 21, 975-980.
5.
Balkwill, F. R., & Burke, F. (1989). The cytokine network. Immunology Today, 10, 299-304.
6.
Barraclough, J. (1996). Adverse life events and breast cancer: Other studies have found no association. British Medical Journal, 312(7034), 845.
7.
Birney, M. H. (1991). Psychoneuroimmunology: A holistic framework for the study of stress and illness. Holistic Nursing Practice, 5, 32-38.
8.
Blaney, P. (1984). Psychological considerations in cancer. In N. Schneiderman & J. Tapp (Eds.), Behavioral medicine: A multi-systems approach. Hillside, NJ: Erlbaum.
9.
Booth, R. J. (1990). The psychoneuroimmune network: Expanding our understanding of immunity and disease. New Zealand Medical Journal, 103(893), 314-316.
10.
Calabrese, J. R. & Wilde, C. (1991). Alterations in immuno competence during stress: A medical perspective. In N. Plotnikoff, A. Murgo, R. Faith, & J. Wybron (Eds.), Stress and immunity, (pp. 81-97). Boca Raton, FL: CRC Press.
11.
Camera, E., & Danao, T. (1989). The brain the immune system: A psychosomatic network. Psychosomatics, 30(2), 140-146.
12.
Cassileth, B. R., Lusk, E. F., Stroose, T. B., & Bodenheimer, B. J. (1984). Contemporary unorthodox treatments in cancer medicine: A study of patients treatments and practitioners. Annals Internal Medicine, 101, 105-112.
13.
Cassileth, B. R. (1996). Stress and the development of breast cancer: A persistent and popular link despite contrary evidence. Cancer, 77,1015-1016.
14.
Caudell, K. (1996). Psychoneuroimmunology and innovative behavioral interventions in patients with leukemia. Oncology Nursing Forum, 23, 493-502.
15.
Chakraborty, A., Chakraborty, N., & Chattopadhyay, U. (1994). Age related natural killer activity of peripheral blood lymphocytes from healthy subjects and cancer patients. A comparative in vitro study with interleukin-2. Tumori, 80, 233-237.
16.
Chen, C. C., David A. S. , Nunnerley, H., Michell, M., Dawson, A. L. , Berry H., Dobbs J., & Fahey, T.Adverse life events and breast cancer: Case control study. British Medical Journal , 311(7019), 1527-1530.
17.
Cohen, F. (1979). Personality, stress, and the development of illness. In G. C. Stone, F. Cohen & N. E. Adlers (Eds.), Health psychology (pp. 77-111). San Francisco, CA: Jossey-Bass.
18.
Cohen, S., Tynell, D. A. J., & Smith, A. P. ( 1991). Psychological stress and susceptibility to the common cold. New England Journal of Medicine, 325, 606-612.
19.
Cole, P., & Amoateng-Adjepong, Y. (1994). Cancer prevention: Accomplishments and prospects. American Journal of Public Health, 84(1), 810.
20.
Cole, P. (1988). Of light bulbs and wine glasses: Risk factors and mortality trends. In R. C. Maulitz (Eds.), Unnatural causes: The three leading killer diseases in America (pp. 83-91). New Brunswick, NJ: Rutgers University Press.
21.
Derogatis, L., Abeloff, M. , & Melisaratos, N. ( 1979). Psychological coping mechanisms and survival time in metastatic breast cancer. Journal of the American Medical Association, 242, 1504-1508.
22.
Eisenberg, D., Kessler, R. C., Foster, C., Norlock, F. E., Calkins, D. R., & Delbamco, T. L. (1993). Unconventional medicine in the United States: Prevalence, costs, and patterns of use. New England Journal of Medicine, 328, 246-252.
23.
Engel, G. (1962). Psychological development in health and disease. Philadelphia, PA: Saunders.
24.
Esterling, B., Antoni, M. , Sehneiderman, N., & Carver, C. (1992). Psychosocial modulation of antibody to Epstein-Barr viral capsid antigen and human herpes virus type-6 in HIV-1 infected and at-risk gay men. Psychosomatic Medicine, 54(3), 354-371.
25.
Esterling, B. A., Kiecolt-Glaser J. K., & Glaser, R. (1996). Psychosocial modulation of cytokine-induced natural killer cell activity in older adults . Psychosomatic Medicine, 58(3), 264-72.
26.
Evans, D., Folds, J., Petitto, J., & Golden, R. (1992). Circulating natural killer cell phenotypes in men and women with major depression: Relation to cytotoxic activity and severity of depression. Archives of General Psychiatry , 49, 388- 395.
27.
Fawzy I., Kemeny, M., Fawzy, N., Elashoff, R., Morton, R., Cousins, N., & Fahey, J. (1990). A structured psychiatric intervention for cancer patients. Archives of General Psychiatry, 47, 729-735.
28.
Felten, D. L., & Felten, S. Y. (1991). Innervation of lymphoid tissue . In R. Ader, D. L. Felton, & N. Cohen (Eds.), Psychoneuroimmunology (pp. 87-101) San Diego, CA : Academic Press.
29.
Felton, D. L., Felton, S. Y., Bellinger, D. L., Carlson. S. L., Ackerman, K., Madden. K. S., Olschowki, J. A., & Livnat, S. (1987). Noradrenergic sympathetic neural interactions with the immune system: Structure and function. Immunological Reviews, 100, 225-260.
30.
Filteau, S., Menzies, R. , Kaido, T., & O'Grady, M. (1992). Effects of exercise on immune functions of undernourished mice. Life Sciences, 51(8), 565-574.
31.
Forsen, A. (1989). Life stress, personality and breast cancer. Monographs of Psychiatria Fennica , 16.
32.
Fox, B. (1978). Premorbid psychological factors as related to cancer incidence. Journal of Behavioral Medicine, 1, 45133.
33.
Goodkin, K., Antoni, M., & Blaney, P. (1986). Stress and hopelessness in the promotion of cervical intraepithelial neoplasia to invasive squamous cell carcinoma of the cervix. Journal of Psychosomatic Research, 30, 67-76.
34.
Goodwin, J., Searles, R. , & Tung, K. (1982 ). Immunological responses of a health elderly population. Clinical and Experimental Immunology, 48, 403-410.
35.
Green, R., & Green, M. (1987). Relaxation increases salivary immunoglobin A1. Psychological Reports, 61, 623-629.
36.
Hahn, R., & Petitti, D. (1988). Minnesota multiphasic personality inventory rated depression and the incidence of breast cancer. Cancer, 61, 845-848.
37.
Herberman, R. B. (1991). Principles of tumor immunology. In A. L. Holleb, D. J. Fink, & G. P. Murphy (Eds.), Textbook of clinical oncology (pp. 69-79). Atlanta, GA: American Cancer Society.
38.
Herbert, T., & Cohen, S. (1993a). Depression and immunity: A meta-analytic review. Psychological Bulletin, 113, 472-486.
39.
Herbert, T. B., & Cohen, S. (1993b). Stress and immunity in humans: A meta-analytic review. Psychosomatic Medicine, 55, 364-379.
40.
Holland, J. (1989). Behavioral and psychosocial risk factors in cancer: Human studies. In J. Holland & J. Rowland (Eds.), Handbook of psychooncology (pp. 717- 726). New York: Oxford Press.
41.
Holmes, T., Hawkins, N., Bowerman, C., Clarke, E. , & Joffe, J. (1957 ). Psychosocial and physiological studies of tuberculosis. Psychosomatic Medicine, 19, 134-143.
42.
Holmes, T. H., & Rahe, R. H. (1967). The social readjustment rating scale. Journal of Psychosomatic Research, 11, 213-218.
43.
Irwin, M.Mascovich, A., Gillin, J., Willoughby, R. , Pike, J., & Smith, T. (1994). Partial sleep deprivation reduces natural killer cell activity in humans. Psychosomatic Medicine, 56, 493-498.
44.
Irwin, M., Lacher, U., & Caldwell, C. (1992). Depression and reduced natural killer cytotoxicity: A longitudinal study of depressed patients and control subjects. Psychological Medicine , 22(4), 1045-1050.
45.
Irwin, M. R., & Strausbaugh, H. (1991). Stress and immune changes in humans: A biopsychosocial model. In J. M. Gorman & R. M. Kertzuer (Eds.), Psychoimmunology update (pp. 55-79).
46.
Jemmott, J., Borysenko, J. , Borysenko, M., McClelland, D., Chapman, R., Meyer, D., & Benson, H. (1984). Academic stress, power motivation, and decrease in secretion rate of salivary secretory immunoglobulin A. Lancet, 321, 1400-1402.
47.
Kiecolt-Glaser, J., & Chee, M. (1991). Personality, stress, and cancer: A reexamination. Psychological Inquiry, 2(3), 249-251.
48.
Kiecolt-Glaser J. K., Fisher, L., Ogrocki, P., Stout, J. C., Speicher, C.E. , & Glaser, R. (1987 ). Marital quality, marital disruption and immune function . Psychosomatic Medicine, 49, 13-34.
49.
Kiecolt-Glaser, J., & Glaser, R. (1987). Psychosocial moderators of immune function. Annals of Behavioral Medicines, 9, 16-20.
50.
Kiecolt-Glaser, J., & Glaser, R. (1988). Commentary: Methodological issues in behavioral immunology research with humans. Brain, Behavior and Immunology, 2, 67-78.
51.
Kiecolt-Glaser, J., & Glaser, R. (1992). Psychoneuroimmunology: Can psychological interventions modulate immunity, Journal of Consulting and Clinical Psychology, 60, 569-575.
52.
Kiecolt-Glaser, J., Glaser, R., Dyer, D., Shuttleworth, E., Ogrocki, P., & Speicher, C. (1987). Chronic stress and immunity in family caregivers for Alzheimer's disease victims . Psychosomatic Medicine, 49, 523-535.
53.
Kiecolt-Glaser, J., Stephens, R., Lipetz, I. P., Speicher, C., & Glaser, R. (1985). Distress and DNA repair in human lymphocytes. Journal of Behavioral Medicine, 8, 311-320.
54.
Kikuchi, T., Kita, T., & Oomori, K. (1988). Interleukin-2 activity in peripheral blood mononuclear cells of patients with gynecologic malignancies. Medical Oncology Tumor Pharmacotherapy , 5, 85-90.
55.
Kiremidjian, S., Roy, M. , Wishe, J., Cohen, M., & Stotzky, G. (1994). Supplementation with selenium and human immune cell functions. II. Effect on cytotoxic lymphocytes and natural killer cells . Biological Trace Elements Research, 41(1-2), 115-127.
56.
Kissen, D. (1966). The significance of personality in lung cancer in men. Annuals of the New York Academy of Science, 125, 820-826.
57.
Krueger, R., Levy, E., Cathcart, E., Fox, B., & Black, P. (1984). Lymphocyte subsets in patients with major depression: Preliminary Endings . Advances, 1, 5-9.
58.
Kusaka, Y., Kondou, H., & Morimoto, K. (1992). Healthy lifestyles are associated with higher natural killer cell activity . Preventive Medicine, 21, 602-615.
59.
LaPerriere, A., Antoni, M. , Schneiderman, N., & Ironson, G. (1990). Exercise intervention attenuates emotional distress and natural killer cell decrements following notification of positive serologic status for HIV-1. Biofeedback and Self-Regulation, 15(3), 125-131.
60.
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer Publishing Co.
61.
Leshan, L. (1966). An emotional life history pattern associated with neoplastic disease. Annals of the New York Academy of Science, 125, 780-793.
62.
Levy, S. M., Herberman, R. B., Lippman, M., & d'Angelo, T. (1987). Correlation of stress factors with sustained depression of natural killer cell activity and predicted prognosis in patients with breast cancer. Journal of Clinical Oncology, 5, 344-353.
63.
Levy, S., Herberman, R., Maluish, A., Schlein, B. , & Lippman, M. ( 1985). Prognostic risk assessment in primary breast cancer by behavioral and immunological parameters. Health Psychology , 4, 99-113.
64.
Levy, S., Herberman, R., Lippman, M., & d'Angelo, T. (1987). Correlation of stress factors with sustained depression of natural killer cell activity and predicted prognosis in patients with breast cancer. Journal of Clinical Oncology , 5, 348- 353.
65.
Levy, S., & Wise, B. (1987). Psychosocial risk factors natural immunity, and cancer progression: Implications for intervention. Special Issue: Health psychology. Current Psychology Research and Reviews , 6(3), 229-243.
66.
Locke, S., & Klaus, L. (1982). Modulation of natural killer cell activity by Life stress and coping ability. In S. Levy (Ed.), Biological mediators of behavior and disease: Neoplasia (pp. 3-28). New York: Elsevier .
67.
Lukomska, B., Waldemar, L. , Engeset, A., & Kolstad, P. (1983). The effect of surgery and chemotherapy on blood NK cell activity in patients with ovarian cancer. Cancer, 51, 465-469.
68.
McCain, N., & Smith, J. (1994). Stress and coping in the context of psychoneuroimmunology : A holistic framework for nursing practice and research . Archives of Psychiatric Nursing, 8, 221-227.
69.
McCulloch, P., & MacIntyre, A. (1993). Effects of surgery on the generation of lymphokine-activated killer cells in patients with breast cancer. British Journal of Surgery, 80, 1005-1007.
70.
McGuigan, F. J. (1993). Progressive relaxation: Origins, principles and clinical applications. In P. Lehrer & R. L. Woolfalk (Eds.), Principle and practice of stress management (2nd ed.), (pp. 17-52). New York: The Guilford Press.
71.
Mills, P. J., & Dimsdale, J. E. (1996). The effects of acute psychotic stress on cellular adhesion molecules. The Journal of Psychosomatic Research, 41(1), 49-53.
72.
Moldofsky, H., Lue, F., Eisen, J., Keystone, M., & Gorczynski, R. (1986). The relationship of interleukin-1 and immune functions to sleep in humans . Psychosomatic Medicine, 48, 309-318.
73.
Morley, J. E., Benton, D. , & Solomon, G. F. ( 1991). The role of stress and opioids as regulators of the immune response. In J. A. McCubbin, P. G. Kaufmann, & C. B. Nemeroff (Eds.), Stress, neuropeptides and systemic disease (pp. 221 -231). San Diego, CA: Academic Press.
74.
Munck, A., & Guyre, P. M. (1991). Glucocorticoids and immune function . In R. Ader, D. L. Felton, & N. Cohen (Eds.), Psychoneuroimmunology (2nd ed.) (pp. 447-474). New York: Academic Press.
75.
Nair, M., Kronfol, Z., Greden, J., Chadha, K., Dumaswala, U., Sweet, A. , & Schwartz, S. ( 1994). Selective inhibition by alcohol and cortisol of natural killer cell activity of lymphocytes from cord blood. Progress in Neuropsychopharmacology and biological Psychiatry, 18, 1293-1395.
76.
Nakamura, M., Morikawa, M. , Koike, H., Sakai, E., Yamaguchi, T., Ebuoka, M., & Komatsu, S. (1994). Reduction in cellular immunity in diabetics receiving coronary artery bypass grafting. Nippon Kyobu Geka Gakkai Zasshi, 42, 1875-1884.
77.
O'Leary, A. (1990). Stress, emotion and human immune function. Psychological Bulletin, 103, 363-382.
78.
Palmblad, J., Petrini, B. , Wasserman, J., & Akerstedt, T. (1979). Lymphocyte and granulocyte reactions during sleep deprivation. Psychosomatic Medicine, 41, 273-278.
79.
Payan, D. G., McGillis, J. P., & Goetzl, E. J. ( 1986). Neuroimmunology. Advanced Immunology , 39, 299-321.
80.
Peric, M., Petrovecki, M. , & Marusic, M. ( 1994). Age-dependent hematological disturbances in anaesthetic personnel chronically exposed to high occupational concentrations of halothane and nitrous oxide. Anaesthesia, 49, 1022-1027.
81.
Rabin, B. S., Cohen, S., Ganguli, R., Lysle, D. T. , & Cunnick, J. E. ( 1989). Bi-directional interaction between the central nervous system and the immune system. Critical Reviews in Immunology , 9, 279-312.
82.
Ramirez, A., Craig, T., Watson, J., Fentiman, J. , North, W., Rubens, R. (1989). Stress and relapse of breast cancer. British Medical Journal, 298, 291-293.
83.
Reichlin, S. (1994). Neuroendocrine-immune interactions. New England Journal of Medicine, 329 (17),1246-1253.
84.
Richardson, M. A., Post-White J., Grimm E., Moye, L., Singletary, E., & Justice B. (1997). Alternative Therapies, 3(5), 62-67.
85.
Roberts, D., Anderson, B. L., & Lubaroff, A. ( 1994). Stress and immunity at cancer diagnosis. Manuscript in preparation.
86.
Selye, H. (1936). A syndrome produced by diverse nocuous agents. Nature, 138 (3479), 32.
87.
Selye, H. (1956). The stress of life. New York: McGraw-Hill.
88.
Siegman, A. W. (1993). Paraverbal correlations of stress: Implications for stress identification and management . In L. Goldberger & S. Breznitz (Eds.), Handbook of stress. Theoretical and clinical aspects (2nd ed.) (p. 275). New York: The Free Press.
89.
Sklar, L., & Anisman, H. (1979). Stress and coping factors influence tumor growth. Science, 205, 513-515.
90.
Solomon, G. (1985). The emerging field of psychoneuroimmunology. Advances, 2(1), 6-19.
91.
Solomon, G. (1987). Psychoneuroimmunology: Interactions between central nervous system and immune system. Journal of Neuroscience Research, 18, 1-9.
92.
Solomon, G., & Moos, R. (1964). Emotions, immunity, and disease: A speculative theoretical integration. Archives of General Psychiatry, 11, 657-674.
93.
Spiegel, D. (1996). Cancer and depression. British Journal of Psychiatry - Supplement, 30, 109-116.
94.
Spiegel, D., Bloom, H. C. , Kramer, & Gottheil, E. (1989). Effects of psychosocial treatment on survival of patients with metastatic breast cancer . The Lancet, 888-901.
95.
Stein, M., Keller, S., & Schleifer, S. (1985). Stress immunomodulation: The role of depression and neuroendocrine function . Journal of Immunology, 135, 827s-833s.
96.
Temoshok, L. (1987). Personality, coping style, emotion and cancer: Towards an integrative model. Cancer Surveys, 6, 545-567.
97.
Thomas, C., Dusyuski, K. , & Shaffer (1979 ). Family attitudes reported in youth as potential predictors of cancer. Psychosomatic Medicine, 41, 287-302.
98.
Voeker, R. (1997). Study examines stress-immune system links and women with breast cancer. Journal of the American Medical Association, 278, 534.
99.
White, D., Jones, D., Cooke, T., & Kirkham, N. (1982). Natural killer (NK) activity in peripheral blood lymphocytes of patients with benign and malignant breast disease. British Journal of Cancer, 46, 611-616.
