{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T17:59:43Z","timestamp":1793642383511,"version":"4.5.1"},"reference-count":73,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,6,27]],"date-time":"2023-06-27T00:00:00Z","timestamp":1687824000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Cancer initiation, progression and recurrence are intricate mechanisms that depend on various components: genetic, psychophysiological, or environmental. Exposure to chronic stress includes fear of recurrence that can affect biological processes that regulate immune and endocrine systems, increase cancer risk, and influence the survival rate. Previous studies show that psychological interventions might influence the level of cortisol that has been extensively used as a biomarker for measuring hypothalamic-pituitary-adrenal axis functioning and body's immunity response. This meta-analysis aimed to provide a quantitative scrutiny of the effect of certain types of psychosocial interventions on cortisol as a neuroendocrine biomarker in saliva or blood and might predict breast cancer (BC) progression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A literature search was performed in the following databases: PubMed, The Cohrane Library, Scopus, WOS, PsychInfo, Google Scholar, Ovid Science Direct. After methodical selection of originally generated 2.021 studies, the search yielded eight articles that met inclusion criteria. All these studies explored effects of psychosocial interventions that measured cortisol in total of 366 participants with BC, stages 0-IV, in randomized control trial or quasi experimental study design setting. We applied random effects model to conduct meta-analyses on the parameters of salivary and plasma cortisol and used PRISMA Guidelines as validated methodology of investigation to report the results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eight studies selected for meta-analysis have shown the reduction of cortisol level due to applied psychosocial intervention. The random effects model showed that interventions produced large effect sizes in reductions of cortisol in blood (Cohen's d = \u22121.82, 95% Confidence Interval (CI): \u22123.03, \u22120.60) and slightly less in saliva (d = \u22121.73, 95%CI: \u22122.68, \u22120.78) with an overall effect of d = \u22121.76 (95%CI: \u22122.46, \u22121.07).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study concluded that certain types of psychosocial interventions reduce cortisol (indicator of chronic stress) in patients with BC. Application of specific psychosocial support as adjuvant non-invasive therapy for affected females with BC at all phases of treatment could contribute to more cost-effective health care.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyg.2023.1148805","type":"journal-article","created":{"date-parts":[[2023,6,27]],"date-time":"2023-06-27T15:12:06Z","timestamp":1687878726000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":34,"title":["Psychosocial interventions reduce cortisol in breast cancer patients: systematic review and meta-analysis"],"prefix":"10.3389","volume":"14","author":[{"given":"Edith","family":"M\u00e9sz\u00e1ros Crow","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"L\u00f3pez-Gigosos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eloisa","family":"Mariscal-L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Agredano-Sanchez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Garc\u00eda-Casares","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Mariscal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Guti\u00e9rrez-Bedmar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,6,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"19","DOI":"10.4993\/acrt.26.19","article-title":"Cortisol and breast cancer: a review of clinical and molecular evidence","volume":"26","author":"Al Sorkhy","year":"2018","journal-title":"Annal. Cancer. Res. Ther."},{"key":"B2","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1016\/j.bbi.2008.09.005","article-title":"Cognitive behavioral stress management effects on psychosocial and physiological adaptation in women undergoing treatment for breast cancer","volume":"23","author":"Antoni","year":"2009","journal-title":"Brain. Behav. Immun"},{"key":"B3","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1038\/nrc1820","article-title":"The influence of bio-behavioural factors on tumour biology: Pathways and mechanisms","volume":"6","author":"Antoni","year":"2006","journal-title":"Nat. Rev. Cancer"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/bcr2836","article-title":"Stress and breast cancer: from epidemiology to molecular biology","volume":"13","author":"Antonova","year":"2011","journal-title":"Breast. Cancer. Res"},{"key":"B5","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.bbi.2008.06.007","article-title":"Neuroendocrine modulation of cancer progression","volume":"23","author":"Armaiz-Pena","year":"2009","journal-title":"Brain. Behav. Immun"},{"key":"B6","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1016\/j.ctcp.2012.03.002","article-title":"A randomised controlled pilot feasibility study of the physical and psychological effects of an integrated support programme in breast cancer","volume":"18","author":"Baker","year":"2012","journal-title":"Complement. Ther. Clin. Pract."},{"key":"B7","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1136\/bmj.j108","article-title":"Psychological distress in relation to site specific cancer mortality: Pooling of unpublished data from 16 prospective cohort studies","volume":"356","author":"Batty","year":"2017","journal-title":"BMJ."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1114","DOI":"10.1111\/j.1365-2648.1994.tb01195.x","article-title":"Psychoneuroimmunology and cancer: an integrated review","volume":"19","author":"Bauer","year":"1994","journal-title":"J. Adv. Nurs"},{"key":"B9","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1002\/1097-0142(19890101)63:1&lt;181::AID-CNCR2820630129&gt;3.0.CO;2-H","article-title":"Relation of tumor size, lymph node status, and survival in 24, 740. breast cancer cases","volume":"63","author":"Carter","year":"1989","journal-title":"Cancer"},{"key":"B10","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1300\/J077v24n01_02","article-title":"A randomized controlled trial of psychosocial interventions using the psychophysiological framework for Chinese breast cancer patients.","volume":"24","author":"Chan","year":"2006","journal-title":"J. Psychosoc. Oncol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"466","DOI":"10.1038\/ncponc1134","article-title":"Do stress-related psychosocial factors contribute to cancer incidence and survival?","volume":"5","author":"Chida","year":"2008","journal-title":"Nat. Clin. Pract. Oncol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1191\/0269216304pm842oa","article-title":"Does psychosocial intervention improve survival in cancer? A meta-analysis","volume":"18","author":"Chow","year":"2004","journal-title":"Palliat. Med"},{"key":"B13","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1200\/JCO.2015.62.3504","article-title":"Annual hazard rates of recurrence for breast cancer during 24 years of follow-up: Results from the international breast cancer study group trials I to V","volume":"34","author":"Colleoni","year":"2016","journal-title":"J. Clin. Oncol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1016\/j.mce.2010.04.005","article-title":"The anti-inflammatory and immunosuppressive effects of glucocorticoids, recent developments and mechanistic insights","volume":"335","author":"Coutinho","year":"2011","journal-title":"Mol. Cell. Endocrinol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1097\/00006842-200005000-00002","article-title":"Cognitive-behavioral stress management reduces serum cortisol by enhancing benefit finding among women being treated for early stage breast cancer","volume":"63","author":"Cruess","year":"2000","journal-title":"Psychosom. Med."},{"key":"B16","doi-asserted-by":"publisher","first-page":"967","DOI":"10.2466\/pr0.1986.59.2.967","article-title":"Effects of biofeedback and cognitive therapy on stress in patients with breast cancer","volume":"59","author":"Davis","year":"1986","journal-title":"Psychol. Rep"},{"key":"B17","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1016\/S0738-3991(99)00030-0","article-title":"Chronic and acute stress as predictors of relapse in primary breast cancer patients","volume":"37","author":"De Brabander","year":"1999","journal-title":"Patient. Educ. Couns"},{"key":"B18","doi-asserted-by":"publisher","first-page":"3599","DOI":"10.1007\/s00520-015-2888-1","article-title":"Feasibility of cognitively-based compassion training (CBCT) for breast cancer survivors: a randomized, wait list controlled pilot study","volume":"23","author":"Dodds","year":"2015","journal-title":"Support. Care. Cancer."},{"key":"B19","doi-asserted-by":"publisher","first-page":"16229","DOI":"10.1186\/cc3040","article-title":"Measurements of serum free cortisol in critically ill patients","volume":"9","author":"Dubey","year":"2005","journal-title":"Crit. Care"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1002\/ijc.11504","article-title":"The association between stressful life events and breast cancer risk: A meta-analysis","volume":"107","author":"Duijts","year":"2003","journal-title":"Int. J. Cancer"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/0960-5428(96)00016-2","article-title":"Psychoneuroimmunology and cancer: Historical perspectives and current research","author":"Fife","year":"1996","journal-title":"Adv. Neuroimmunol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/j.cpnec.2022.100110","article-title":"Predisposing factors for increased cortisol levels in oral cancer patients","volume":"9","author":"Figueira","year":"2022","journal-title":"Compr. Psychoneuroendocrinol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/S0165-1781(99)00008-6","article-title":"On the role of immunological factors as mediators between psychosocial factors and cancer progression","volume":"85","author":"Garssen","year":"1999","journal-title":"Psychiatry. Res"},{"key":"B24","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1038\/nri1571","article-title":"Stress-induced immune dysfunction: Implications for health","volume":"5","author":"Glaser","year":"2005","journal-title":"Nat. Rev. Immunol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/BF00999510","article-title":"Immunological responses of breast cancer patients to behavioral interventions","volume":"18","author":"Gruber","year":"1993","journal-title":"Biofeedback. Self. Regul"},{"key":"B26","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3390\/jcm9010209","article-title":"The effectiveness of psychological treatments in women with breast cancer: a systematic review and meta-analysis","volume":"9","author":"Guarino","year":"2020","journal-title":"J. Clin. Med"},{"key":"B27","unstructured":"HigginsJ. P. T.\n            Savovi\u0107J.\n            PageM. J.\n            ElbersR. G.\n            SterneJ. A. C.\n          Chapter 8: Assessing Risk of Bias in a Randomized Trial. Cochrane Handbook for Systematic Reviews of Interventions Version 6, 32022"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1159\/000329178","article-title":"The effects of psychotherapy on psychological well-being and diurnal cortisol patterns in breast cancer survivors","author":"Hsiao","year":"2012","journal-title":"Psychother. Psychosom"},{"key":"B29","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1177\/1534735416636222","article-title":"A systematic review of spiritually based interventions and psychoneuroimmunological outcomes in breast cancer survivorship","volume":"15","author":"Hulett","year":"2016","journal-title":"Integr. Cancer. Ther"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/14651858.CD008729.pub2","article-title":"Psychological interventions for women with non-metastatic breast cancer","volume":"2015","author":"Jassim","year":"2015","journal-title":"Cochrane. Database. Syst. Rev"},{"key":"B31","doi-asserted-by":"publisher","first-page":"275","DOI":"10.5483\/BMBRep.2015.48.4.275","article-title":"Technical and clinical aspects of cortisol as a biochemical marker of chronic stress","volume":"48","author":"Lee","year":"2015","journal-title":"BMB. Rep"},{"key":"B32","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1177\/1099800418789777","article-title":"A Large Randomized Trial: Effects of Mindfulness-Based Stress Reduction (MBSR) for Breast Cancer (BC) Survivors on Salivary Cortisol and IL-6","volume":"21","author":"Lengacher","year":"2019","journal-title":"Biol. Res. Nurs"},{"key":"B33","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/j.physbeh.2006.08.025","article-title":"Measuring cortisol in human psychobiological studies","volume":"90","author":"Levine","year":"2007","journal-title":"Physiol. Behav"},{"key":"B34","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1097\/00006842-198809000-00008","article-title":"Survival hazards analysis in first recurrent breast cancer patients: Seven-year follow-up","volume":"50","author":"Levy","year":"1988","journal-title":"Psychosom. Med"},{"key":"B35","doi-asserted-by":"publisher","first-page":"1839","DOI":"10.1073\/pnas.1424171112","article-title":"Suppression of cancer relapse and metastasis by inhibiting cancer stemness","volume":"112","author":"Li","year":"2015","journal-title":"Proc. Natl. Acad. Sci. U. S. A"},{"key":"B36","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1756-9966-32-53","article-title":"Striking life events associated with primary breast cancer susceptibility in women: a meta-analysis study","volume":"32","author":"Lin","year":"2013","journal-title":"J. Exp. Clin. Cancer. Res."},{"key":"B37","doi-asserted-by":"publisher","first-page":"4094","DOI":"10.1200\/JCO.2009.26.9357","article-title":"Host factors and cancer progression: Biobehavioral signaling pathways and interventions","volume":"28","author":"Lutgendorf","year":"2010","journal-title":"J. Clin. Oncol."},{"key":"B38","doi-asserted-by":"publisher","first-page":"996","DOI":"10.1177\/0193945910385363","article-title":"Effects of mindfulness-based stress reduction (MBSR) on health among breast cancer survivors","volume":"33","author":"Matchim","year":"2011","journal-title":"West. J. Nurs. Res"},{"key":"B39","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1016\/j.ctcp.2009.06.004","article-title":"Cortisol as a marker for improvement in mindfulness-based stress reduction","volume":"16","author":"Matousek","year":"2010","journal-title":"Complement. Ther. Clin. Pract"},{"key":"B40","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.bbi.2008.08.002","article-title":"Psychological intervention and health outcomes among women treated for breast cancer: a review of stress pathways and biological mediators","volume":"23","author":"McGregor","year":"2009","journal-title":"Brain. Behav. Immun"},{"key":"B41","doi-asserted-by":"publisher","first-page":"2178","DOI":"10.3390\/cancers14092178","article-title":"Cytokines: can cancer get the message?","volume":"14","author":"Morris","year":"2022","journal-title":"Cancers."},{"key":"B42","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1002\/pon.2960010305","article-title":"Do psychosocial factors influence the course of breast cancer?","volume":"1","author":"Mulder","year":"1992","journal-title":"Psychooncology"},{"key":"B43","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1002\/14651858.CD004253.pub4","article-title":"Psychological interventions for women with metastatic breast cancer","volume":"2013","author":"Mustafa","year":"2013","journal-title":"Cochrane. Datab. Syst. Rev."},{"key":"B44","doi-asserted-by":"publisher","first-page":"djv178","DOI":"10.1093\/jnci\/djv178","article-title":"Evidence of a causal association between insulinemia and endometrial cancer: a mendelian randomization analysis","volume":"107","author":"Nead","year":"2015","journal-title":"J. Natl. Cancer. Inst"},{"key":"B45","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1016\/j.jpsychores.2007.07.004","article-title":"Relaxation and guided imagery program in patients with breast cancer undergoing radiotherapy is not associated with neuroimmunomodulatory effects","volume":"63","author":"Nunes","year":"2007","journal-title":"J. Psychosom. Res"},{"key":"B46","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1080\/08870446.2015.1111370","article-title":"Meta-analysis of psychosocial interventions on survival time in patients with cancer","volume":"31","author":"Oh","year":"2016","journal-title":"Psychol. Health"},{"key":"B47","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1136\/bmj.296.6624.741","article-title":"Aromatase activity in adipose tissue from breast quadrants: a link with tumour site","volume":"296","author":"O'Neill","year":"1988","journal-title":"Br. Med. J."},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1038\/sj.npp.1301012","article-title":"Relationship between cortisol responses to stress and personality","author":"Oswald","year":"2006","journal-title":"Neuropsychopharmacology"},{"key":"B49","doi-asserted-by":"publisher","first-page":"1583","DOI":"10.1371\/journal.pmed.1003583","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"18","author":"Page","year":"2021","journal-title":"PLoS. Med"},{"key":"B50","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1111\/j.2042-3306.2010.00294.x","article-title":"Comparison between blood serum and salivary cortisol concentrations in horses using an adrenocorticotropic hormone challenge","volume":"43","author":"Peeters","year":"2011","journal-title":"Equine. Vet. J"},{"key":"B51","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1348\/135910799168434","article-title":"Adverse life-events and risk of breast cancer: A meta-analysis","volume":"4","author":"Petticrew","year":"1999","journal-title":"Br. J. Health. Psychol"},{"key":"B52","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1007\/s10608-011-9398-3","article-title":"Stress management skills and reductions in serum cortisol across the year after surgery for non-metastatic breast cancer","volume":"35","author":"Phillips","year":"2011","journal-title":"Cognit. Ther. Res"},{"key":"B53","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1590\/S0102-311X2009001500010","article-title":"Association between stress and breast cancer in women: a meta-analysis","volume":"25","author":"Santos","year":"2009","journal-title":"Cad. Saude. Publica"},{"key":"B54","doi-asserted-by":"publisher","first-page":"5349","DOI":"10.1002\/cncr.24561","article-title":"Depression as a predictor of disease progression and mortality in cancer patients: a meta-analysis","volume":"115","author":"Satin","year":"2009","journal-title":"Cancer"},{"key":"B55","first-page":"336","author":"Schedlowski","year":"1994","journal-title":"The Effects of Psychological Intervention on Cortisol Levels and Leukocyte Numbers in the Peripheral Blood of Breast Cancer Patients. The Psychoimmunology of Cancer: Mind and Body in the Fight for Survival? Oxford: Oxford. University. Press"},{"key":"B56","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.bbi.2007.02.002","article-title":"PNI and cancer: are we there yet?","volume":"21","author":"Schleifer","year":"2007","journal-title":"Brain. Behav. Immun"},{"key":"B57","doi-asserted-by":"publisher","first-page":"994","DOI":"10.1093\/jnci\/92.12.994","article-title":"Diurnal cortisol rhythm as a predictor of breast cancer survival","volume":"92","author":"Sephton","year":"2000","journal-title":"J. Natl. Cancer. Inst"},{"key":"B58","doi-asserted-by":"publisher","first-page":"7042","DOI":"10.1158\/0008-5472.CAN-10-0522","article-title":"The sympathetic nervous system induces a metastatic switch in primary breast cancer","volume":"70","author":"Sloan","year":"2010","journal-title":"Cancer. Res"},{"key":"B59","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1016\/S0022-3999(03)00575-0","article-title":"Meta-analysis of the effects of psychosocial interventions on survival time in cancer patients","volume":"57","author":"Smedslund","year":"2004","journal-title":"J. Psychosom. Res"},{"key":"B60","doi-asserted-by":"crossref","DOI":"10.1111\/j.1749-6632.1998.tb09606.x","volume-title":"Effects of Psychosocial Treatment in Prolonging Cancer Survival May be Mediated by Neuroimmune Pathways","author":"Spiegel","year":"1998"},{"key":"B61","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1177\/1534735413503548","article-title":"Psychosocial therapies for patients with cancer: a current review of interventions using psychoneuroimmunology-based outcome measures","volume":"13","author":"Subnis","year":"2014","journal-title":"Integr. Cancer. Ther"},{"key":"B62","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1016\/j.semcancer.2007.12.005","article-title":"Neuroendocrine influences on cancer biology","volume":"18","author":"Thaker","year":"2008","journal-title":"Semin. Cancer. Biol"},{"key":"B63","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1097\/PSY.0b013e3181b0545c","article-title":"A psychological intervention reduces inflammatory markers by alleviating depressive symptoms: Secondary analysis of a randomized controlled trial","volume":"71","author":"Thornton","year":"2009","journal-title":"Psychosom. Med"},{"key":"B64","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1007\/s00432-013-1516-z","article-title":"Effects of psycho-behavioral interventions on immune functioning in cancer patients: a systematic review","volume":"140","author":"Tong","year":"2014","journal-title":"J. Cancer. Res. Clin. Oncol"},{"key":"B65","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1159\/000056271","article-title":"An exploratory study into the effect of group psychotherapy on cardiovascular and immunoreactivity to acute stress in breast cancer patients","volume":"70","author":"van der Pompe","year":"2001","journal-title":"Psychother. Psychosom"},{"key":"B66","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1016\/S0022-3999(96)00393-5","article-title":"Effectiveness of a short-term group psychotherapy program on endocrine and immune function in breast cancer patients: an exploratory study","volume":"42","author":"van der Pompe","year":"1997","journal-title":"J. Psychosom. Res"},{"key":"B67","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1016\/j.bbi.2012.10.022","article-title":"The influence of glucocorticoid signaling on tumor progression","volume":"30","author":"Volden","year":"2013","journal-title":"Brain. Behav. Immun"},{"key":"B68","doi-asserted-by":"publisher","first-page":"25","DOI":"10.2174\/1876391X00901010025","article-title":"Mind-body medicine and immune system outcomes: a systematic review","volume":"1","author":"Wahbeh","year":"2009","journal-title":"Open. Complement. Med. J"},{"key":"B69","doi-asserted-by":"publisher","first-page":"141","DOI":"10.4103\/0973-1075.179607","article-title":"Impact of emotional support on serum cortisol in breast cancer patients","volume":"22","author":"Webster","year":"2016","journal-title":"Indian. J. Palliat. Care"},{"key":"B70","first-page":"58","article-title":"Methodological guidelines prior to the use of salivary cortisol as biological marker of stress","volume":"32","author":"Weibel","year":"2003","journal-title":"Presse. Medicale"},{"key":"B71","doi-asserted-by":"publisher","first-page":"969","DOI":"10.1016\/j.bbi.2008.01.012","article-title":"Effect of mindfulness based stress reduction on immune function, quality of life and coping in women newly diagnosed with early stage breast cancer","volume":"22","author":"Witek-Janusek","year":"2008","journal-title":"Brain. Behav. Immun"},{"key":"B72","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ctim.2016.02.012","article-title":"Effects of mindfulness-based therapy for patients with breast cancer: a systematic review and meta-analysis","volume":"26","author":"Zhang","year":"2016","journal-title":"Complement. Ther. Med"},{"key":"B73","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1097\/MD.0000000000017228","article-title":"Psychological intervention and its immune effect in cancer patients: a meta-analysis","volume":"98","author":"Zhang","year":"2019","journal-title":"Medicine"}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2023.1148805\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,27]],"date-time":"2023-06-27T15:12:12Z","timestamp":1687878732000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2023.1148805\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,27]]},"references-count":73,"alternative-id":["10.3389\/fpsyg.2023.1148805"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2023.1148805","relation":{},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,27]]},"article-number":"1148805"}}