Other Titles
Rising Star Poster/Presentation
Abstract
Introduction: Racial and economic cancer treatment disparities pose a major public health challenge. Pre-existing psychosocial stressors and overall "weathering" or allostatic load are often more profound among patients of color and those from areas of high deprivation and may impact cancer outcomes.
Purpose: This study characterized baseline allostatic load, lifetime stress, perceived discrimination, financial toxicity, quality of life, distress, symptom burden, and resilience, compared by race and area deprivation.
Methods: This analysis was drawn from the prospective, observational ALLEGIANT (Allostasis, Cellular Aging, and Cancer Outcomes) study. Patients initiating cancer therapy were recruited from cancer clinics in Western Pennsylvania. Measures included financial toxicity (COST), quality of life (FACT-G), distress (Distress Thermometer), perceived discrimination (Lifetime Discrimination Scale), perceived stress (Perceived Stress Scale), symptom burden (Memorial Symptom Assessment Scale), resilience (Connor-Davidson Resilience Scale), and allostatic load. Allostatic load (0-8) was calculated as a composite of blood pressure, body mass index, waist circumference, HDL cholesterol, triglycerides, hemoglobin A1c, and C-reactive protein. Baseline characteristics were compared by race (Black/White self-report) and area deprivation index (calculated from residential address) using descriptive, comparative, and correlational statistics.
Results: Fifty-seven patients were recruited from Western Pennsylvania oncology clinics. Mean allostatic load was 3.30 (SD 1.52), with no significant differences by race or ADI. There was a significant correlation between higher allostatic load and worse financial toxicity (r = −0.275, p < 0.05). Higher area deprivation was significantly associated with worse financial toxicity (r = −0.304, p < 0.05), higher psychological stress, and lower health literacy (r = −0.282, p < 0.05).
Discussion: All adults initiating chemotherapy exhibited moderate physiological weathering, as reflected in allostatic load. Further work needs to characterize the impact of allostatic load on cancer outcomes. These findings underscore the need for early, systematic screening for financial and psychosocial stressors in oncology settings.
Notes
References:
Chan, R. J., Gordon, L. G., Tan, C. J., Chan, A., Bradford, N. K., Yates, P., & Miaskowski, C. (2019). Relationships between financial toxicity and symptom burden in cancer survivors: a systematic review. Journal of pain and symptom management, 57(3), 646-660. https://doi.org/10.1016/j.jpainsymman.2018.12.003
de Alcantara Nogueira, L., Lenhani, B. E., Tomim, D. H., & Kalinke, L. P. (2020). Financial toxicity. Asian Pacific Journal of Cancer Prevention: APJCP, 21(2), 289. https://doi.org/10.31557/APJCP.2020.21.2.289
Doan, S. N. (2021). Allostatic load: Developmental and conceptual considerations in a multisystem physiological indicator of chronic stress exposure. Developmental psychobiology, 63(5), 825-836.
Jackson, C. L., Dagher, R. K., Byun, J. S., Farhat, T., & Gardner, K. L. (2021). Getting under the skin: Pathways and processes that link social and biological determinants of disease. In The science of health disparities research (pp. 13–38). Bethesda, MD: National Institutes of Health.
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McDowell, I. (2023). Biological pathways linking social determinants to health. In Understanding health determinants: Explanatory theories for social epidemiology (pp. 161–203). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-031-19129-9_7
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Podder, V., Sarfraz, Z., Qidwai, K. A., Maharaj, A., Ranjan, T., Aulakh, S., & Ahluwalia, M. S. (2025). Gaps in Diagnosis, Treatment, and Outcomes Among Patients with Brain Tumors in the United States: A State-of-the-Art Review. Cancers, 17(24), 3982. https://doi.org/10.3390/cancers17243982
Rosenzweig, M. Q., Nugent, B., & McGuire, M. (2023). Impact of Race and Area Deprivation on Triple-Negative Metastatic Breast Cancer Outcomes. In Oncology Nursing Forum (Vol. 50, No. 4). DOI 10.1188/23.ONF.449-457
Rosenzweig, M. Q., Wiehagen, T., Brufsky, A., & Arnold, R. (2009). Challenges of illness in metastatic breast cancer: A low-income African American perspective. Palliative & Supportive Care, 7(2), 143–152. https://doi.org/10.1017/S1478951509000192
Rosenzweig, M., Belcher, S. M., Braithwaite, L. E., Cuaron, L., Fischer-Cartlidge, E., Lally, R. M., & Anderson, A. (2024). Research Priorities of the Oncology Nursing Society: 2024–2027. In Oncology nursing forum (Vol. 51, No. 6, p. 502).
Sedrak, M. S., Sun, C. L., Ji, J., Cohen, H. J., Gross, C. P., Tew, W. P., Muss, H. B. (2023). Low-Intensity Adjuvant Chemotherapy for Breast Cancer in Older Women: Results from the Prospective Multicenter HOPE Trial. Journal of Clinical Oncology, 41(2), 316-326. https://doi.org/10.1200/JCO.22.01440
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Sigma Membership
Non-member
Type
Poster
Format Type
Text-based Document
Study Design/Type
Secondary Analysis
Research Approach
Quantitative Research
Keywords:
Psychological Stress, Physiological Stress, Cancer Patients, Cancer Treatment, Cancer Chemotherapy
Recommended Citation
Speakman, Campbell; Rosenzweig, Margaret Quinn; and Komladzah, Emmanuel, "Baseline Psychosocial Stress and Allostatic Load in Patients Initiating Cancer Therapy" (2026). International Nursing Research Congress (INRC). 106.
https://www.sigmarepository.org/inrc/2026/posters_2026/106
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Invited Presentation
Acquisition
Proxy-submission
Date of Issue
2026-09-17
Baseline Psychosocial Stress and Allostatic Load in Patients Initiating Cancer Therapy
Toronto, Ontario, Canada
Introduction: Racial and economic cancer treatment disparities pose a major public health challenge. Pre-existing psychosocial stressors and overall "weathering" or allostatic load are often more profound among patients of color and those from areas of high deprivation and may impact cancer outcomes.
Purpose: This study characterized baseline allostatic load, lifetime stress, perceived discrimination, financial toxicity, quality of life, distress, symptom burden, and resilience, compared by race and area deprivation.
Methods: This analysis was drawn from the prospective, observational ALLEGIANT (Allostasis, Cellular Aging, and Cancer Outcomes) study. Patients initiating cancer therapy were recruited from cancer clinics in Western Pennsylvania. Measures included financial toxicity (COST), quality of life (FACT-G), distress (Distress Thermometer), perceived discrimination (Lifetime Discrimination Scale), perceived stress (Perceived Stress Scale), symptom burden (Memorial Symptom Assessment Scale), resilience (Connor-Davidson Resilience Scale), and allostatic load. Allostatic load (0-8) was calculated as a composite of blood pressure, body mass index, waist circumference, HDL cholesterol, triglycerides, hemoglobin A1c, and C-reactive protein. Baseline characteristics were compared by race (Black/White self-report) and area deprivation index (calculated from residential address) using descriptive, comparative, and correlational statistics.
Results: Fifty-seven patients were recruited from Western Pennsylvania oncology clinics. Mean allostatic load was 3.30 (SD 1.52), with no significant differences by race or ADI. There was a significant correlation between higher allostatic load and worse financial toxicity (r = −0.275, p < 0.05). Higher area deprivation was significantly associated with worse financial toxicity (r = −0.304, p < 0.05), higher psychological stress, and lower health literacy (r = −0.282, p < 0.05).
Discussion: All adults initiating chemotherapy exhibited moderate physiological weathering, as reflected in allostatic load. Further work needs to characterize the impact of allostatic load on cancer outcomes. These findings underscore the need for early, systematic screening for financial and psychosocial stressors in oncology settings.
Description
This study aims to characterize baseline physiological stress and examine how it affects outcomes in patients with cancer.