Sylvester Comprehensive Cancer Center

Michael Antoni, Ph.D.

Michael Antoni, Ph.D.

Professor of Psychology

Description of Research

Dr. Antoni’s research interests focus on examining the effects of stressors and stress management interventions on the adaptation to, and physical course of, diseases such as breast cancer, cervical neoplasia, prostate cancer, chronic fatigue syndrome, and human immunodeficiency virus (HIV) infection. He also has examined some of the psychobiological mechanisms that might explain ways in which stressful events and psychosocial interventions contribute to the adaptation to these diseases. Much of this work specifically examines psychological intervening variables (stress appraisal processes, coping behaviors, and social resources) and biological/physiological variables (neuroendocrine and immune system functioning) that may explain the effects of psychosocial interventions on quality of life and health outcomes in cancer patients undergoing medical treatments. The overarching goal of this research program is to develop theoretically-driven and empirically-supported psychosocial interventions to use in the primary, secondary, and tertiary prevention of cancer.

Dr. Antoni has been funded from the NIH/NCI for the past three decades to conduct multiple randomized clinical trials of a group-based cognitive behavioral stress management (CBSM) intervention he developed for women undergoing treatment for breast cancer, and men and women treated for HIV/AIDS. Dr. Antoni also directed a National Cancer Institute-funded P50 Center for Psycho-Oncology Research (CPOR), conducting biobehavioral research on the interrelationships between cognition, emotions, biological processes, and physical health through several randomized clinical trials that test the effects of CBSM intervention on psychosocial and physiological adaptation in populations at high risk for cancer or those individuals dealing with treatment for breast or prostate cancer. The CPOR conducted 4 clinical trials and managed 5 core laboratories dedicated to providing psychosocial and biological mechanism and outcome data as well as statistical/data management. A number of program investigators, including those from the Departments of Microbiology and Immunology, Obstetrics and Gynecology, Psychology, Psychiatry and Behavioral Science, and Medicine, have conducted CPOR pilot studies designed to elaborate on biobehavioral pathways explored in the CPOR parent trials.

This work led to individual R01 and R21 projects by program investigators, and some of the cores were used in the design of the Non-Therapeutic Research Core, a shared resource in the Cancer Center and the Neuroimmunology Laboratory facility that serves Biobehavioral Oncology investigators. Most of these research efforts have focused on using information derived from studies that examine the effects of stressors to develop stress reduction techniques to target specific biobehavioral processes, and to create interventions that are sensitive to the sociodemographic and cultural characteristics of the target groups. This has resulted in the development of treatment manuals that can be used as a model for conducting intervention groups.

Moreover, this work has led to the development and testing of brief group-based interventions for clinic use, community-based interventions for ethnic minority and Spanish-speaking populations of cancer patients and survivors, and telephone/web-delivered interventions for home-based delivery to patients. This work is unified in investigating the efficacy and underlying biobehavioral mechanisms in explaining the effects of these different approaches on psychological adaptation, quality of life and health during treatment and into survivorship. Many of these studies examine behavioral pathways, while biological pathways and inflammatory processes are measured through biochemical and molecular analyses. Finally, investigators explore the relative effects of these interventions among ethnic/racial minorities to better understand healt


  • Showed that group-based cognitive behavioral stress management improves mood, symptoms, and quality of life; reduces hormonal indicators of stress (serum cortisol), and increases cellular immune system functioning and Th1 cytokine production over a 12-month period in women undergoing treatment for breast cancer.
  • Showed that women with breast cancer reporting greater depressive symptoms and negative mood early in treatment show greater leukocyte gene expression for pro-inflammatory and pro-metastatic processes, and greater circulating levels of pro-inflammatory cytokines in the weeks following surgery.
  • Demonstrated for the first time that group-based stress management (CBSM) alters leukocyte transcriptional dynamics in breast cancer patients with decreased leukocyte expression of pro-inflammatory genes for cytokines (IL-1-beta, IL-6, TNF-alpha), and chemokines (CCL2, CCL3, CCL3L1), tissue remodeling and epithelial-mesenchymal transition (LMNA, MMP9) at 6 and 12-month follow-up. These changes were paralleled by increased expression of Type-I interferon activation genes. Bioinformatics analyses implicated decreases in NF-kappa B and GATA transcripts and increased glucocorticoid receptor sensitivity in mediating these changes.
  • Demonstrated that women participating in a group-based 10 week CBSM intervention during primary treatment for breast cancer show less depressive symptoms and better quality of life 8 – 15 years later.
  • Demonstrated that 5 weeks of group-based relaxation or cognitive behavioral intervention improves psychological adaptation (decreased depressed mood, cancer-specific intrusive thoughts, and interpersonal disruption) during primary treatment for breast cancer.
  • Awarded a grant from the Florida Breast Cancer Foundation in 2014 to examine the molecular mechanisms underlying the effects of 5-week stress management interventions effects on psychological adaptation, quality of life and health in women undergoing treatment for breast cancer.
  • Showed that a 10-week CBSM decreases perceived stress and reduces the odds of progression of cervical neoplasias in women co-infected with HIV and Human Papillomavirus (HPV) as well as improving immune system reconstitution and decreasing HIV viral RNA in other HIV-infected populations.

Selected Cancer-Related Publications

  • Byrne MM, Tannenbaum SL, Glück S, Hurley J, Antoni M. Participation in Cancer Clinical Trials: Why Are Patients Not Participating? Med Decis Making :,2013 Read more »
  • Jean-Pierre P, Winters PC, Ahles TA, Antoni M, Armstrong FD, Penedo F, Lipshultz SE, Miller TL, Fiscella K. Prevalence of self-reported memory problems in adult cancer survivors: a national cross-sectional study. J Oncol Pract 8:30-4,2012 Read more »
  • Antoni MH. Psychosocial intervention effects on adaptation,disease course and biobehavioral processes in cancer. Brain Behav Immun :,2012 Read more »
  • Penedo FJ, Benedict C, Zhou ES, Rasheed M, Traeger L, Kava BR, Soloway M, Czaja S, Antoni MH. Association of Stress Management Skills and Perceived Stress with Physical and Emotional Well-Being Among Advanced Prostrate Cancer Survivors Following Androgen Deprivation Treatment. J Clin Psychol Med Settings :,2012 Read more »
  • Traeger L, Penedo FJ, Benedict C, Dahn JR, Lechner SC, Schneiderman N, Antoni MH. Identifying how and for whom cognitive-behavioral stress management improves emotional well-being among recent prostate cancer survivors. Psychooncology :,2011 Read more »
  • Kinsinger SW, Laurenceau JP, Carver CS, Antoni MH. Perceived partner support and psychosexual adjustment to breast cancer. Psychol Health 26:1571-1588,2011 Read more »
  • Steel J, Geller DA, Tsung A, Marsh JW, Dew MA, Spring M, Grady J, Likumahuwa S, Dunlavy A, Youssef M, Antoni M, Butterfield LH, Schulz R, Day R, Helgeson V, Kim KH, Gamblin TC. Randomized controlled trial of a collaborative care intervention to manage cancer-related symptoms: lessons learned. Clin Trials 8:298-310,2011 Read more »
  • Lutgendorf SK, Mullen-Houser E, Russell D, Degeest K, Jacobson G, Hart L, Bender D, Anderson B, Buekers TE, Goodheart MJ, Antoni MH, Sood AK, Lubaroff DM. Preservation of immune function in cervical cancer patients during chemoradiation using a novel integrative approach. Brain Behav Immun 24:1231-40,2010 [JIF 5.061] Read more »
  • Zhou ES, Penedo FJ, Bustillo NE, Benedict C, Rasheed M, Lechner S, Soloway M, Kava BR, Schneiderman N, Antoni MH. Longitudinal effects of social support and adaptive coping on the emotional well-being of survivors of localized prostate cancer. J Support Oncol 8:196-201,2010 Read more »
  • Zhou ES, Penedo FJ, Lewis JE, Rasheed M, Traeger L, Lechner S, Soloway M, Kava BR, Antoni MH. Perceived stress mediates the effects of social support on health-related quality of life among men treated for localized prostate cancer. J Psychosom Res 69:587-90,2010 [JIF 2.908] Read more »
  • Steel JL, Kim KH, Dew MA, Unruh ML, Antoni MH, Olek MC, Geller DA, Carr BI, Butterfield LH, Gamblin TC. Cancer-related symptom clusters, eosinophils, and survival in hepatobiliary cancer: an exploratory study. J Pain Symptom Manage 39:859-71, 2010 Read more »
  • Vargas S, Wohlgemuth WK, Antoni MH, Lechner SC, Holley HA, Carver CS. Sleep dysfunction and psychosocial adaptation among women undergoing treatment for non-metastatic breast cancer. Psychooncology 19:669-73, 2010 Read more »
  • Lutgendorf SK, Sood AK, Antoni MH. Host factors and cancer progression: biobehavioral signaling pathways and interventions. J Clin Oncol 28:4094-9, 2010 Read more »


Collaborating in the Multidisciplinary Research Program(s):

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