UC Irvine

Background. Children diagnosed with cancer experience pain and myriad psychosocial symptoms throughout their disease progression and treatment which negatively impact their quality of life. Caregivers of children with cancer are also at risk for poorer psychosocial outcomes, including increased stress. Oral and systemic inflammation may be associated with psychosocial outcomes and pain in children and stress in caregivers, however this has not been studied extensively. The present study aims to 1) measure salivary inflammatory biomarker concentrations in children undergoing treatment for cancer and their primary caregivers; 2) determine how salivary inflammatory biomarkers are related to patient- and caregiver-reported pain and psychosocial outcomes; 3) investigate the impact of Pain Buddy, a mobile health (mHealth) ambulatory symptom management intervention, on salivary biomarkers of inflammation in both children and caregivers; and 4) explore factors that may be associated with salivary biomarkers of inflammation.Method. Children ages 8 to 18 with a first-time cancer diagnosis were recruited along with one primary caregiver (N = 22 dyads) to take part in a randomized controlled trial (RCT) over 8 weeks. Children reported their daily pain and cancer-related symptoms via a mobile application while receiving usual care. The intervention group (n = 14) received remote symptom monitoring and skills training for pain management and the attention-control group (n = 8) only reported on their pain. Child-caregiver dyads completed questionnaires at baseline, at the end of the intervention period, and at six months post-intervention. Dyads also collected saliva samples for three consecutive days at questionnaire timepoints along with reports of oral health, diet, and current medications. Results. Intercorrelations of salivary biomarkers and relationships between salivary biomarkers, pain, and psychosocial outcomes were examined among children and caregivers. In exploratory analyses, correlations were found between cancer diagnosis category and children’s T3 salivary TNF-α (rpb= -.358), as well as between cancer diagnosis category and caregivers’ baseline salivary IL-6 (rpb= .52). Conclusion. Overall, findings from the present study provide insight and novel methodology for studying potential immune processes (i.e., inflammation) associated with cancer among children within the first six months of a first-time diagnosis and their caregivers. The present study highlights the need for additional research with larger participant samples among children with cancer and their caregivers to determine how factors such as cancer diagnosis, medications, and self-reports of well-being may be related to salivary inflammatory biomarkers.