stress keeps women away from treatment

stress keeps women away from treatment
stress keeps women away from treatment

How much can stress influence the degree of adherence and the effectiveness of treatments? The question arose in the field of oncology, with women followed for breast cancer. According to the results of a study revealed at an online conference *, “allostatic load” is the marker involved in this correlation.

But what does this charge correspond to? It “refers to the idea of ​​global biological wear resulting from adaptation to the environment via stress response systems. The allostatic load is therefore the price paid by the organism over time to adapt to the demands of the environment ”, detailed the authors of the Weekly Epidemiological Bulletin (BEH) in June 2016.

According to American scientists ** present at the said congress, the allostatic load is “particularly high in people exposed to a form of isolation, precariousness and racism”. In the long term, it creates an increased risk of health problems such as “high blood pressure, increased body mass index, kidney disease, inflammation, arthritis and other disorders”.

BMI, blood pressure, creatine levels

In the context of cancer, this link between allostatic load and therapeutic efficacy has its place. “The behavior of the patient in the face of the disease and the therapeutic outcomes cannot be isolated from the impact of his social environment”, confirms Pr Samilia Obeng-Gyasi, oncologist surgeon, main author of the study. “The allostatic load is therefore the objective marker to assess this point. “

To assess its impact in real life, Prof. Obeng-Gyasi’s team analyzed the results of the phase III clinical trial ECOG-ACRIN. In total, the files of 348 breast cancer patients *** were analyzed. In addition to the allostatic load, several criteria were noted: cardiovascular biomarkers, the immune and metabolic system before the start of treatments, but also the body mass index, blood pressure, the level of creatine and several cytokines indicating inflammatory state.

According to their observations, “patients with a high allostatic load have a greater probability of stopping their chemotherapy during treatment and are thus exposed to an increased risk of death, compared to those with a low allostatic load and continuing their treatment. “. In detail, “each time the allostatic load increases by one point, the probability of not going to the end of the chemotherapy increases by 15%, and by 14% concerning the increased risk of death”.

“In the future, the allostatic load could constitute a tool for predicting therapeutic adherence and limiting the risk of therapeutic withdrawal”, the scientists conclude.

*14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved, organisé du 6 au 8 octobre

**The Ohio State University Comprehensive Cancer Center

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Source: Destination Santé

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