Sylvester Researchers Receive $2.7 Million Grant to Study Stress Management for Breast Cancer Survivors
Summary
- Sylvester Comprehensive Cancer Center researchers received a $2.7 million grant to study stress management in breast cancer survivorship.
- The SMART-PATHS study will test a telehealth cognitive behavioral stress management program to reduce cancer-associated aging.
- Researchers will track biological markers of stress, inflammation, immune function and aging over two years.
Researchers at Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, have received a $2.7 million grant to study whether a structured stress management program following breast cancer treatment can improve long-term health outcomes and slow cancer-associated aging in survivors.
A multidisciplinary team from the University of Miami will evaluate the impact of a telehealth-based cognitive behavioral stress management intervention on biological and psychological markers of aging and well-being in breast cancer survivors over several years.
Stress Management and Cancer Survivorship
The study, Stress Management and Relaxation Training: Preventing Aging Toward Healthy Survivorship (SMART-PATHS), is led by principal investigator Michael Antoni, Ph.D., director of health psychology at UM, in collaboration with Frank Penedo, Ph.D., director of Sylvester Survivorship and Supportive Care Institute (SSCI), and breast cancer oncologist Carmen Calfa, M.D., medical director of SSCI and an associate professor in the Miller School’s Division of Medical Oncology.
“The work is the first to test the effects of a telehealth cognitive behavioral stress management (CBSM) intervention to slow cancer-associated aging (CAA) and optimize longer-term health outcomes in breast cancer survivors,” said Dr. Calfa. “Sylvester is not only interested in developing new treatment strategies to enhance the chances of curing the cancer but is equally committed to mitigating the negative impact of cancer treatment.”
Cancer Treatment, Stress and Aging
Dr. Antoni has studied the effects of stress on individuals with chronic illness at Sylvester for nearly three decades.
“I’ve always been interested in how life stress, the stress of treatment, the stress of having cancer, may contribute to biological processes such as inflammation,” he said. “And those, in turn, can relate to poor health outcomes.”
Cancer and treatments such as chemotherapy can accelerate cellular aging, which can impair immune, hormonal and brain function. Even after treatment ends, many survivors experience persistent emotional distress, including fear of recurrence and concerns about immune or hormonal changes. According to Dr. Antoni, this ongoing stress may continue to drive cellular aging and negatively affect long-term health.
Over time, Dr. Antoni and his team developed cognitive behavioral stress management, an intervention that combines cognitive behavioral therapy with relaxation techniques, including breathing exercises and progressive muscle relaxation.
The team pilot-tested the program using a telehealth platform that allowed participants to attend 10 live group sessions over 10 weeks and access educational videos, demonstrations, expert content and an on-demand resource guide. This format significantly reduced barriers to participation compared with in-person sessions.
Compared with patients placed on a waitlist, participants who completed the program reported lower psychological distress and showed improved immune cell metabolic function and slower cellular aging.
“We saw that the women who showed the greatest reductions in distress and the greatest increases in stress management skills were the women who had the greatest slowing of the T- and B-cell metabolism,” said Dr. Antoni, suggesting a reduction in cancer-associated aging.
The telehealth program also demonstrated strong engagement, with high attendance at live sessions and frequent use of on-demand resources.
Inside the SMART-PATHS Telehealth Intervention
The new study will enroll 192 postmenopausal breast cancer survivors with elevated distress levels over the next three years as they transition from active treatment to survivorship.
“This period is crucial because chronic stress can accelerate biological aging, and the intervention aims to mitigate this,” said Dr. Antoni.
Dr. Penedo added, “Postmenopausal women are the largest survivor group in the U.S., and they face persistent stress-related symptoms, elevated aging biomarkers and earlier onset of age-related morbidity compared to peers without cancer.”
Participants will complete the virtual CBSM program while researchers monitor stress levels, inflammation, endocrine function and immune cell metabolism for up to two years. Dr. Antoni is collaborating with Daniela Frasca, Ph.D., research professor in the Miller School’s Department of Microbiology and Immunology and a member of the Tumor Biology Program at Sylvester.
The research team will use a digital wearable tracker to track sleep, physical activity and heart rate variability, a measure associated with the body’s ability to manage physical and emotional stress. Researchers will also analyze cortisol levels through saliva samples and measure inflammatory biomarkers in blood at multiple time points during the study.
“My interest in Dr. Antoni’s studies comes from the observation that a large majority of breast cancer survivors are older and are characterized by high levels of inflammaging, which is known to lead to immune cell senescence and elevated risk of infectious diseases, as well as to mental health challenges such as depression, anxiety and poor quality of life, all referred to as cancer accelerated aging,” said Dr. Frasca. “Therefore, the discovery that a stress management intervention improves the quality of life of these patients through immune-mediated mechanisms has been of extreme interest to me.”
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