By Marilyn Elias
Gannett News Service

Early-stage breast cancer may be most likely to kill women who had suffered severe stress - a family death, divorce, financial crisis - in the year before diagnosis, according to a new study.

The research tracked 80 patients over seven years, starting within a year of their diagnosis. There were 20 recurrences and 15 deaths. "It's a very small study to be making any sweeping conclusion. But it does pose questions that need to be followed up on," says Frances Visco, president of the National Breast Cancer Coalition, an education and advocacy group in Washington, D.C.

The women, all diagnosed with Stage 2 cancer that had not been detected beyond the lymph nodes, filled out questionnaires about stressors in their lives.

Severe stress after their cancer diagnosis had no relation to recurrence or death, says psychiatrist Karen Weihs of George Washington University School of Medicine in Washington, D.C. But major troubles in the year before diagnosis nearly tripled the women's odds of having a recurrence or dying from the disease, Weihs says. She and co-author Diane Blyler spoke to the American Psychosomatic Society recently in Phoenix.

Breast cancer is so stressful that it may swamp any other hassles, blurring the differences in life stress among the women after diagnosis, Weihs speculates.

But terrible jolts in the year before getting diagnosed could affect the body's ability to fight off disease, she says. Women in the study had sons fighting AIDS, had lost their jobs and faced other traumas. "Their immune system may already be maxed out," says Weihs, so they could be vulnerable to more lethal forms of cancer.

Psychologist Steven Tovian says he sees no tie between life stress before diagnosis and dying, "but it would be difficult to prove either way."

"We are learning more and more that stress does affect the immune system, though we're not at a point yet to say it causes cancer. There are so many individual differences in immune function, and stress affects people differently," says Tovian, director of the health psychology program at Evanston Northwestern Healthcare in Evanston, Ill.

Weihs intends to repeat the study with 500 patients.