In the current study, the higher level of serum cortisol in the control arm in comparison to the intervention arm were evident with significant statistical margins and correlate well with pain scores in the intervention arm. Raised serum cortisol has been reported as an indicator of clinical stage of the disease also.[18] One more study confirms high rates of behavioral symptoms in breast cancer survivors, particularly those treated with chemotherapy and indicates a role for tumor necrosis factor‑signaling as a contributor to post‑chemotherapy fatigue. Results also suggest that fatigue, sleep disturbance, and depression may stem from distinct biologic processes in post‑treatment survivors, with inflammatory signaling contributing relatively specifically to fatigue.[20]