Relationship between social support, quality of life, and Th2 cytokines in a biobehavioral cancer survivorship trial

  • Kathryn OsannEmail author
  • Justin Wilford
  • Lari Wenzel
  • Susie Hsieh
  • Jo A. Tucker
  • Aditi Wahi
  • Bradley J. Monk
  • Edward L. Nelson
Original Article



Benefits of social support (SS) during cancer survivorship are complex. This study examines change in SS over time in cervical cancer (CXCA) survivors who have completed definitive treatment and how changing SS impacts quality of life (QOL) and T-helper type 2 (Th2) cytokines.


We conducted a randomized trial in 204 CXCA survivors to test if psychosocial telephone counseling (PTC) could improve QOL compared to usual care (UC). Although PTC did not target SS, data were collected at baseline, 4 and 9 months post-enrollment using the Medical Outcomes Survey Social Support scale. Biospecimens were collected to investigate associations with patient-reported outcomes. Data were analyzed using multivariate linear models and stepwise regression.


Participants’ mean age was 43. PTC participants experienced increasing SS compared to UC at 4 months (PTC-UC = 5.1; p = 0.055) and 9 months (PTC-UC = 6.0; p = 0.046). Higher baseline SS and increasing SS were independently associated with improved QOL at 4 and 9 months after adjusting for patient characteristics (p < 0.05). Differences between study arms were not statistically significant. Improvements in QOL at 4 months were observed with increases in emotional/informational and tangible SS. Increasing SS predicted significant longitudinal decreases in IL-4 and IL-13 at 4 months that were larger in the PTC arm (interactions p = 0.041 and p = 0.057, respectively).


Improved SS was significantly associated with improved QOL independent of patient characteristics and study arm. Decreasing Th2 cytokines with increasing SS and QOL are consistent with a biobehavioral paradigm in which modulation of the chronic stress response is associated with shifts in immune stance.


Cancer survivorship Quality of life Social support 



The authors acknowledge the support and contributions of Paige Green, PhD MPH.

Compliance with ethical standards

Conflict of interest

All authors have declared no conflict of interest. All primary data is under full control of LW and may be reviewed by the journal if requested.


This work was supported by the National Cancer Institute of the National Institutes of Health under award numbers RO1 CA118136-01, P30 CA062203, and P20 CA174188. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Kathryn Osann
    • 1
    • 2
    Email author
  • Justin Wilford
    • 3
  • Lari Wenzel
    • 2
    • 3
    • 4
  • Susie Hsieh
    • 2
    • 4
  • Jo A. Tucker
    • 1
  • Aditi Wahi
    • 2
    • 4
  • Bradley J. Monk
    • 5
  • Edward L. Nelson
    • 1
    • 2
    • 6
  1. 1.Department of Medicine, Division of Hematology/OncologyUniversity of California IrvineIrvineUSA
  2. 2.Chao Family Comprehensive Cancer CenterUniversity of California IrvineIrvineUSA
  3. 3.Program in Public HealthUniversity of California IrvineIrvineUSA
  4. 4.Department of MedicineUniversity of California IrvineIrvineUSA
  5. 5.School of Medicine, St. Joseph’s Hospital and Medical CenterCreighton UniversityPhoenixUSA
  6. 6.Institute for ImmunologyUniversity of California IrvineIrvineUSA

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