Stress, coping, and circadian disruption among women awaiting breast cancer surgery

Abstract

Background Psychological distress and coping related to a breast cancer diagnosis can profoundly affect psychological adjustment, possibly resulting in the disruption of circadian rest/ activity and cortisol rhythms, which are prognostic for early mortality inmetastatic colorectal and breast cancers, respectively. Purpose This study aims to explore the relationships of cancer-specific distress and avoidant coping with rest/activity and cortisol rhythmdisruption in the period between diagnosis and breast cancer surgery. Methods Fifty-seven presurgical breast cancer patients provided daily self-reports of cancer-specific distress and avoidant coping as well as actigraphic and salivary cortisol data. Results Distress and avoidant coping were related to rest/ activity rhythm disruption (daytime sedentariness, inconsistent rhythms). Patients with disrupted rest/activity cycles had flattened diurnal cortisol rhythms. Conclusions Maladaptive psychological responses to breast cancer diagnosis were associated with disruption of circadian rest/activity rhythms. Given that circadian cycles regulate tumor growth, we need greater understanding of possible psychosocial effects in cancer-related circadian disruption. © The Society of Behavioral Medicine 2012.