Julienne E. Bower, PhD

Studying the biological pathways that link psychological stress and breast cancer outcomes, with a focus on the nervous and immune systems.

Impact

Patients who have been diagnosed and treated for breast cancer experience many forms of stress including psychological stress which can activate the immune response and cause inflammation—this negatively impacts breast cancer outcomes. Compelling evidence has emerged that indicates that the immune response and inflammation play a role in tumor initiation, progression, and metastatic spread. Drs. Bower and Cole are focusing on the role of the nervous and immune systems in translating stress from brain to body. These studies aim to define new “positive neurobiology” pathways that can be translated into clinical interventions. Through this work, they hope to establish new paradigms for blocking stress in order to promote both the quality and potentially the length of breast cancer survivorship.

Progress Thus Far

Drs. Bower and Cole are conducting several interrelated lines of research into the association between psychosocial stressors and tumor characteristics in women with early-stage breast cancer. This includes examination of neural processes that link chronic stress and inflammatory processes relevant for tumor progression, as well as intervention studies to reduce stress and identify neuroendocrine pathways that impact tumor biology. In recent work, they established a role for the brain’s reward system in blocking stress-induced changes in tumor biology which led them to develop a laboratory model system to study how to leverage this effect to impact breast cancer growth and metastasis. In other lines of investigation, they demonstrated that an online version of their mindfulness-based intervention is effective in reducing depression, enhancing well-being, and improving tumor-relevant immune processes in younger women with a history of breast cancer. Building on this, the team developed and pilot-tested a new digital intervention that teaches breast cancer survivors specific skills—such as savoring, gratitude, and positive reappraisal—to increase well-being and reduce stress. In preclinical work, they made a striking discovery: activating the brain’s reward system stimulates the production of dendritic cells, immune sentinels that launch the T cell responses the body needs to recognize and kill cancer cells—and that are the primary targets of modern cancer immunotherapies.

What’s next

Drs. Bower and Cole will continue their clinical work to test and expand their digital intervention. In addition to this clinical work, they will continue to evaluate their model of reward system activation and evaluate how activation of the brain’s reward system affects breast cancer growth and metastasis. Both lines of research are designed to establish new parameters for enhancing psychological well-being and blocking the stress effect for breast cancer survivors: Their results have the potential to not only advance new digital health interventions in breast cancer care but also define new “positive neurobiology” pathways that might be tapped in future clinical tools.

Read more about Dr. Bower’s work as part of BCRF’s Health Equity Initiative here.