Religion and spirituality among patients with localized prostate cancer.

OBJECTIVE: To examine: (1) daily religious and spiritual experiences among localized prostate cancer patients as compared to a national age and race-matched male sample; (2) cognitive-affective and clinical predictors of prostate cancer diagnosis-related increases in religiosity and spirituality; (3) short-term impact of daily religious and spiritual experiences on cancer recurrence worry. METHODS: Analyses of data from a longitudinal questionnaire study among patients (N = 254) diagnosed with localized prostate cancer and data from a random sample (N = 238) of respondents to the national General Social Survey. RESULTS: Compared to the national sample, prostate cancer patients reported higher levels of daily spiritual experiences. Patients with higher worry about prostate cancer and elevated levels of prostate-related symptoms around diagnosis were more likely to report a diagnosis-related increase in religiosity and spirituality. Positive benefits (reduced recurrence worry) of religious coping/practices were restricted to those patients with higher versus lower level of postdiagnosis increase in religiosity; patients not reporting postdiagnosis increases in religion who are not engaging in religious coping/practice adjusted equally well. Results suggest that the development of religious/spiritual interventions is premature. SIGNIFICANCE OF RESULTS: This is the first prospective study to report on the prevalence and influence of daily spiritual and religious experiences among prostate cancer patients.

Clinical, demographic and psychosocial correlates of complementary and alternative medicine use by men diagnosed with localized prostate cancer.

PURPOSE: We examined complementary and alternative medicine (CAM) use among men who received standard therapy for localized prostate cancer. MATERIALS AND METHODS: A total of 417 men completed a questionnaire 6 months after their treatment decision assessing clinical and psychosocial variables and use of 41 available CAM therapies grouped into the 2 general categories of herbal/dietary and nonherbal (i.e. mind-body, bioelectromagnetic, traditional/folk medicine, pharmacological/biological). RESULTS: The prostate cancer diagnosis prompted 19% of our sample to start using some form of CAM for prostate health, and 67% of men reported having used some form of CAM for prostate health before being diagnosed. Initiation of CAM was associated with being a member of an ethnic minority group and a higher level of education. Initiation of nonherbal CAM was associated with being married, while use of herbal CAM therapies was significantly associated with choosing observation. Herbal use before diagnosis was associated with being white, higher level of education and being single. Prostate specific antigen at diagnosis, Gleason score, quality of life, participant perceptions of seriousness of prostate cancer or self-reported worry about prostate cancer were not related to initiation or prior use. Of those men reporting current use almost 50% did not inform their treating physician of using CAM therapies. CONCLUSIONS: Initiation of CAM therapies as a result of a prostate cancer diagnosis was fairly low, although two-thirds of men had used it before diagnosis. Half of the patients did not inform their physicians about such use and physicians should continue to probe patients about CAM use.

Being popular can be healthy or unhealthy: stress, social network diversity, and incidence of upper respiratory infection.

Diverse social contacts are generally associated with better health. However, diverse contacts can increase exposure to infectious agents. This should increase risk for disease, particularly among those whose host resistance is otherwise compromised (e.g., stressed individuals). In this prospective study, healthy college students who completed questionnaires assessing social network diversity and stressful life events were subsequently interviewed weekly for 12 weeks to track incidence of upper respiratory infections (URIs). URI episodes were defined by a symptom criterion and by clinically verified self-reported illness. Stress and diversity of social contacts interacted; diversity was associated with more illnesses among those with more stressful life events and slightly fewer illnesses among those with fewer stressful life events. Associations remained after controlling for neuroticism.

Reactivity and vulnerability to stress-associated risk for upper respiratory illness.

OBJECTIVE: We tested the hypothesis that the greater a person's laboratory stress-elicited elevation in cortisol, the greater the life stress-related risk for upper respiratory infection (URI). We also tested the prediction that the greater the laboratory stress-elicited rise in natural killer cell (NK) cytotoxicity, the smaller the life stress-related URI risk. Finally, we explored whether sympathetic nervous system (SNS) and enumerative immune reactivities to laboratory stress moderate the relation between life stress and URI. METHODS: At baseline, 115 healthy subjects were administered a negative stressful life events checklist and were tested to assess their SNS (blood pressure, heart rate, and catecholamines), HPA (cortisol), and immune (NK cell cytotoxicity and lymphocyte subsets) reactivities to laboratory speech tasks administered 2 weeks apart. Responses were averaged across the two laboratory assessments to create reactivity scores. After these assessments were completed, participants were followed weekly for 12 consecutive weeks. At each follow-up they completed a measure of perceived stress experienced over the last week. They were also instructed to contact the study coordinator if they had a cold or flu at any time during follow-up. A health care worker verified reported illnesses. RESULTS: In a traditional prospective analysis, high cortisol reactors with high levels of life events had a greater incidence of verified URI than did high reactors with low levels of life events and low reactors irrespective of their life event scores. Using hierarchical linear modeling, CD8(+) number, Natural Killer (NK) cell number, and NK cell cytotoxicity, each interacted with weekly perceived stress levels in predicting concurrent occurrences of self-reported URIs. For these outcomes, low immune reactors were more likely to experience an URI during high stress than low stress weeks. High immune reactors did not exhibit differences in weekly URIs as a function of weekly stress level. The SNS reactivity markers did not moderate the association of stress and URI incidence in either analysis. CONCLUSIONS: Acute HPA and immune responses to laboratory stressors are markers of how vulnerable people are to the increased risk for URI associated with stressors in the natural environment.