To assess the effect of psychosocial and cultural factors on survival of patients with metastatic renal cell carcinoma and investigate the association between immune function and psychosocial variables. Specifically, we seek to assess the correlation between depressive symptoms, social support, coping skill, and religious factors (level of intrinsic religiousness, organized religious activity, and non-organized religious activity) on time to recurrence or progression and survival.
The study is designed to detect a survival difference between patients by their scores on the Hoge IR scale, the ORA scale, in the NORA scale, SF-36 Quality of Life Measure, the COPE, the CES-D, and the Duke Social Support Index. We will obtain two blood samples to examine dendritic cell function, NK cell numbers and cytotoxicity, circulating levels of Interferon and Interleukin 2, 4 and 10, and genetic and molecular markers. We will also obtain saliva samples for cortisol assays. One sample will be obtained at the recruitment visit (before any systemic treatment). To determine the circadian nature of cortisol, five samples a day (waking, 45 minutes later, 8 and 12 hours later, and at bedtime) will be obtained for three consecutive days (again before any systemic treatment). A single sample will also be obtained at the 6-month visit. |