Researcher links hormone to cancer patients' life span

A seven-year study by a new UofL faculty member published in the June 21 issue of the Journal of the National Cancer Institute shows that women with advanced breast cancer who have abnormal daytime levels of a stress-related hormone are more likely to die sooner than other patients.

UofL psychiatry researcher Sandra Sephton found the link between the hormone, cortisol, and breast cancer survival while she was a post-doctoral fellow at Stanford University. David Spiegel, professor of psychiatry at Stanford, was the principal investigator.

The study involved 104 San Francisco Bay area women with cancer that had spread beyond the breast.

The work expands on a 1989 study published in The Lancet in which Spiegel and his colleagues reported that women with metastatic cancer (cancer that had spread beyond the breast) who attended psychotherapy groups lived about twice as long as those who had no psychosocial intervention.

Based on this and other studies, Dr. Sephton decided to look to the daily rhythms of the cortisol system for a possible physiological explanation for the difference in mortality.

Women participating in the study were asked to collect their saliva four times daily over a three-day period. The researchers were able to reliably measure levels of cortisol in the saliva.

They also obtained blood samples in order to measure specific types of immune system cells. The group found that only 37 percent of the women had cortisol rhythms that were normal, starting with a high level in the morning and maintaining a steady decline throughout the day.

The other 63 percent had rhythms with a relatively flat pattern that peaked abnormally.

Women with abnormal cortisol rhythms survived an average of 3.2 years while those with normal rhythms survived an average of 4.5 years.

The difference in survival times began emerging about a year after the testing and continued for at least six years after, the researchers reported.

At UofL, Dr. Sephton is studying how stress and cortisol rhythms relate to disease symptoms in women with fibromyalgia. Her husband, David Simpson, is a Research Challenge Trust Fund hire in the University of Louisville's Department of Urban and Public Affairs.