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Cruz E, Mendez A, Ting A, Spiegel D, Tsai TC, Carver CS, Kim Y. The associations of spirituality and Hispanic ethnicity with neuroendocrine biomarkers among patients with colorectal cancer. J Psychosom Res 2024; 185:111865. [PMID: 39116686 PMCID: PMC11357898 DOI: 10.1016/j.jpsychores.2024.111865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 07/19/2024] [Accepted: 07/21/2024] [Indexed: 08/10/2024]
Abstract
OBJECTIVE Dealing with cancer evokes not only physical and emotional distress, but may also promote resilience through spirituality. Patients with cancer are vulnerable to neuroendocrine dysregulation. This longitudinal observational study examined the degree to which spirituality was associated with neuroendocrine biomarkers and the moderating role of Hispanic ethnicity. METHODS Participants were adults who were recently diagnosed with colorectal cancer (n = 81, 55 years old, 66% male, 63% Hispanic, 72% advanced cancer, 7 months post-diagnosis). The domains of spirituality (faith, meaning, and peace) and ethnicity (Hispanic vs. non-Hispanic) were self-reported. Cortisol and alpha amylase (sAA) were assayed from saliva samples collected at waking and bedtime on seven consecutive days. Mean levels at waking and bedtime, and diurnal slopes over seven days were calculated. Age and cancer stage were covariates. RESULTS Overall, patients reported moderate to high levels of spirituality. General linear modeling revealed that greater faith was associated with higher levels of sAA at waking and bedtime as well as more blunted diurnal pattern of sAA only among Hispanic patients (p ≤ .045). Greater peace was associated with steeper diurnal pattern of sAA, regardless of ethnicity (B = 0.021, p = .005). Meaning and cortisol were not significantly associated with study variables. CONCLUSIONS Findings indicate that presence of peace facing a cancer diagnosis associated with neuroendocrine regulation, whereas drawing on one's faith, particularly among Hispanic patients, associated with neuroendocrine dysregulation during the first months after the diagnosis. Further investigations of psychobiobehavioral moderators and mediators for healthy neuroendocrine functioning among patients with cancer are warranted.
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Affiliation(s)
| | | | - Amanda Ting
- Department of Psychology, University of Miami, USA
| | - David Spiegel
- Department of Psychiatry & Behavioral Sciences, Stanford University, USA
| | | | | | - Youngmee Kim
- Department of Psychology, University of Miami, USA.
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Gomez A, Wu Y, Zhang C, Boyd L, Wee TL, Gewolb J, Amor C, Cheadle L, Borniger JC. A brain-body feedback loop driving HPA-axis dysfunction in breast cancer. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.09.13.612923. [PMID: 39314280 PMCID: PMC11419152 DOI: 10.1101/2024.09.13.612923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/25/2024]
Abstract
Breast cancer patients often exhibit disrupted circadian rhythms in circulating glucocorticoids (GCs), such as cortisol. This disruption correlates with reduced quality of life and higher cancer mortality 1-3 . The exact cause of this phenomenon - whether due to treatments, stress, age, co-morbidities, lifestyle factors, or the cancer itself remains unclear. Here, we demonstrate that primary breast cancer alone blunts host GC rhythms by disinhibiting neurons in the hypothalamus, and that circadian phase-specific neuromodulation of these neurons can attenuate tumor growth by enhancing anti-tumor immunity. We find that mice with mammary tumors exhibit blunted GC rhythms before tumors are palpable, alongside increased activity in paraventricular hypothalamic neurons expressing corticotropin-releasing hormone (i.e., PVN CRH neurons). Tumor-bearing mice have fewer inhibitory synapses contacting PVN CRH neurons and reduced miniature inhibitory post-synaptic current (mIPSC) frequency, leading to net excitation. Tumor-bearing mice experience impaired negative feedback on GC production, but adrenal and pituitary gland functions are largely unaffected, indicating that alterations in PVN CRH neuronal activity are likely a primary cause of hypothalamic-pituitary-adrenal (HPA) axis dysfunction in breast cancer. Using chemogenetics (hM3Dq) to stimulate PVN CRH neurons at different circadian phases, we show that stimulation just before the light-to-dark transition restores normal GC rhythms and reduces tumor progression. These mice have significantly more effector T cells (CD8+) within the tumor than non-stimulated controls, and the anti-tumor effect of PVN CRH neuronal stimulation is absent in mice lacking CD8+ T cells. Our findings demonstrate that breast cancer distally regulates neurons in the hypothalamus that control output of the HPA axis and provide evidence that therapeutic targeting of these neurons could mitigate tumor progression.
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Galin M, de Girolamo L, Clarisse B, Segura-Djezzar C, Glöckner F, Elia C, Réhel S, Clochon P, Doidy F, Chavant J, Etard O, Viader F, Grellard JM, Lequesne J, Joly F, Eustache F, Martin T, Giffard B, Quarck G, Perrier J. Exploration of effects of galvanic vestibular stimulation on circadian rhythms and its associations with sleep and spatial memory in patients with breast cancer: The ICANSLEEP-2 protocol. PLoS One 2024; 19:e0306462. [PMID: 39083526 PMCID: PMC11290633 DOI: 10.1371/journal.pone.0306462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 05/29/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Patients with breast cancer (BC) exhibit circadian rhythm disruptions, mainly of rest-activity rhythm (RAR), of which sleep is an essential component, and cortisol rhythm. Sleep complaints such as insomnia and cognitive impairments are prevalent in BC. In general population, sleep is known to contribute greatly to cognition. Thus, improving RAR (and particularly sleep) could help limiting cognitive impairments in BC patients. It has recently been suggested that, in addition to its essential role in spatial memory, the vestibular system contributes to RAR synchronization. Its stimulation could therefore limit both sleep disturbances and spatial memory deficits in BC. OBJECTIVES The main aim of the ICANSLEEP-2 study is to assess the effects of galvanic vestibular stimulation (GVS) on circadian rhythms. The secondary aim is to assess whether GVS improves sleep and spatial memory in BC patients. METHODS Two groups with insomnia complaints (Insomnia Severity Index > 7) will be included: a patients' group with BC (n = 50) and a healthy control group without history of cancer (n = 25). There will be two assessment sessions, before and after 2 weeks of GVS. Patients will be randomly assigned to either a GVS group or a sham group (noneffective stimulation). Controls will receive GVS. GVS effects will be quantified and compared between groups. Assessments will include actigraphy, salivary cortisol, polysomnography, a cognitive test battery (including a computer-based task for spatial memory) and validated questionnaires (for psychological functioning and sleep complaints). DISCUSSION Current methods for improving sleep in BC have had controversial outcomes regarding sleep structure. We expect GVS to offer a new mean of directly targeting RAR disruptions in BC patients, with beneficial effects on sleep structure. Given the crucial impact of sleep on cognitive functioning, notably spatial memory, improving sleep of BC patients should enhance their cognitive functioning. ETHICS AND DISSEMINATION This study received ethical approval from the Ile de France IV institutional review board on 19 April 2022 (no. ID-RCB: 2022-A00437-36). The findings yielded by this protocol will be presented at various conferences and in peer-reviewed journals. CLINICALTRIALS.GOV REGISTRATION NUMBER NCT05414357.
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Affiliation(s)
- Melvin Galin
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
- COMETE Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Laura de Girolamo
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | | | | | - Franka Glöckner
- Faculty of Psychology, Chair of Lifespan Developmental Neuroscience, TU Dresden, Dresden, Germany
| | - Clara Elia
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Stéphane Réhel
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Patrice Clochon
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Franck Doidy
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Julien Chavant
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Olivier Etard
- COMETE Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Fausto Viader
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | | | - Justine Lequesne
- Clinical Research Department, François Baclesse Center, Caen, France
| | - Florence Joly
- Clinical Research Department, François Baclesse Center, Caen, France
- Cancer and Cognition Platform, French League Against Cancer, Caen, France
- Cancer Prevention and Treatment (ANTICIPE) Research Unit, INSERM, Normandy University, Caen, France
| | - Francis Eustache
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Tristan Martin
- Movement – Interactions, Performance (MIP) Team, Faculty of Sciences and Technologies, Le Mans University, Le Mans, France
| | - Bénédicte Giffard
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
- Cancer and Cognition Platform, French League Against Cancer, Caen, France
| | - Gaëlle Quarck
- COMETE Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Joy Perrier
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
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Elia C, de Girolamo L, Clarisse B, Galin M, Rehel S, Clochon P, Doidy F, Segobin S, Viader F, Naveau M, Delcroix N, Segura-Djezzar C, Grellard JM, Lequesne J, Etard O, Martin T, Quarck G, Eustache F, Joly F, Giffard B, Perrier J. Effects of sleep disturbances and circadian rhythms modifications on cognition in breast cancer women before and after adjuvant chemotherapy: the ICANSLEEP-1 protocol. BMC Cancer 2023; 23:1178. [PMID: 38041077 PMCID: PMC10693085 DOI: 10.1186/s12885-023-11664-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 11/21/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Many patients treated for breast cancer (BC) complain about cognitive difficulties affecting their daily lives. Recently, sleep disturbances and circadian rhythm disruptions have been brought to the fore as potential contributors to cognitive difficulties in patients with BC. Yet, studies on these factors as well as their neural correlates are scarce. The purpose of the ICANSLEEP-1 (Impact of SLEEP disturbances in CANcer) study is to characterize sleep using polysomnography and its relationship with the evolution of cognitive functioning at both the behavioral and the neuroanatomical levels across treatment in BC patients treated or not with adjuvant chemotherapy. METHODS ICANSLEEP-1 is a longitudinal study including BC patients treated with adjuvant chemotherapy (n = 25) or not treated with adjuvant chemotherapy (n = 25) and healthy controls with no history of BC (n = 25) matched for age (45-65 years old) and education level. The evaluations will take place within 6 weeks after inclusion, before the initiation of chemotherapy (for BC patients who are candidates for chemotherapy) or before the first fraction of radiotherapy (for BC patients with no indication for chemotherapy) and 6 months later (corresponding to 2 weeks after the end of chemotherapy). Episodic memory, executive functions, psychological factors, and quality of life will be assessed with validated neuropsychological tests and self-questionnaires. Sleep quantity and quality will be assessed with polysomnography and circadian rhythms with both actigraphy and saliva cortisol. Grey and white matter volumes, as well as white matter microstructural integrity, will be compared across time between patients and controls and will serve to further investigate the relationship between sleep disturbances and cognitive decline. DISCUSSION Our results will help patients and clinicians to better understand sleep disturbances in BC and their relationship with cognitive functioning across treatment. This will aid the identification of more appropriate sleep therapeutic approaches adapted to BC patients. Improving sleep in BC would eventually help limit cognitive deficits and thus improve quality of life during and after treatments. TRIAL REGISTRATION NCT05414357, registered June 10, 2022. PROTOCOL VERSION Version 1.2 dated March 23, 2022.
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Affiliation(s)
- Clara Elia
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, 14000, France
| | - Laura de Girolamo
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, 14000, France
| | - Bénédicte Clarisse
- Clinical Research Department, Centre François Baclesse, Caen, 14076, France
| | - Melvin Galin
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, 14000, France
- Normandie Université, UNICAEN, INSERM, COMETE U1075, CYCERON, CHU Caen, Caen, 14000, France
| | - Stéphane Rehel
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, 14000, France
| | - Patrice Clochon
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, 14000, France
| | - Franck Doidy
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, 14000, France
| | - Shailendra Segobin
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, 14000, France
| | - Fausto Viader
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, 14000, France
- Neurology Department, CHU de Caen, Caen, 14000, France
| | - Mikaël Naveau
- Normandie Université, UNICAEN, CNRS UAR 3408, INSERM US-50, GIP Cyceron, Caen, France
| | - Nicolas Delcroix
- Normandie Université, UNICAEN, CNRS UAR 3408, INSERM US-50, GIP Cyceron, Caen, France
| | | | | | - Justine Lequesne
- Clinical Research Department, Centre François Baclesse, Caen, 14076, France
| | - Olivier Etard
- Normandie Université, UNICAEN, INSERM, COMETE U1075, CYCERON, CHU Caen, Caen, 14000, France
| | - Tristan Martin
- Faculty of Sciences and Technologies, Le Mans University, Avenue Olivier Messiaen, Movement, Interactions, Performance, Le Mans, 4334, 72000, MIP, EA, France
| | - Gaëlle Quarck
- Normandie Université, UNICAEN, INSERM, COMETE U1075, CYCERON, CHU Caen, Caen, 14000, France
| | - Francis Eustache
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, 14000, France
| | - Florence Joly
- Clinical Research Department, Centre François Baclesse, Caen, 14076, France
- Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, Caen, 14076, France
- ANTICIPE (Interdisciplinary Research Unit for the Prevention and Treatment of Cancer), INSERM Unit 1086, Caen, France
| | - Bénédicte Giffard
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, 14000, France
- Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, Caen, 14076, France
- Pôle des Formations et de Recherche en Santé, 2 rue des Rochambelles, Caen Cedex, CS-14032, France
| | - Joy Perrier
- Normandie Univ, UNICAEN, PSL Université, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, 14000, France.
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Gu S, Xu Y, Zhu X, Lam A, Yi D, Gong L, Wang J, Guo X, Fu L, Shi J, Wang F, Liu K. Characteristics of cancer-related fatigue and its correlation with anxiety, depression, and stress-related hormones among Chinese cancer survivors: a cross-sectional study. Front Oncol 2023; 13:1194673. [PMID: 37965458 PMCID: PMC10641402 DOI: 10.3389/fonc.2023.1194673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 10/05/2023] [Indexed: 11/16/2023] Open
Abstract
Background Fatigue is a common source of distress for cancer survivors. The severity of cancer-related fatigue varies significantly, which may be due to individual differences in host factors. Aim This cross-sectional study aims to explore how demographic, oncological, sociological, psychological, and stress-related hormones levels interact to influence the distinct experiences of fatigue (Cancer-related fatigue [CRF] occurrence and fatigue degree). Methods A cross-sectional study carried out at the oncology outpatient and ward department of Xiyuan Hospital of China Academy of Chinese Medical Sciences recruited 306 cancer patients between January 2021 to December 2021. General information, fatigue, psychological factors was evaluated by general information questionnaire, the Revised Piper's Fatigue Scale-Chinese Version (RPFS-CV), and the self-report Hospital Anxiety and Depression Scale (HADS). Stress-related hormones were measured with chemiluminescent enzyme immunoassay (Zhengzhou Antobio). Results 306 patients were included, 229 (74.8%) were diagnosed with CRF, including 94 (41.0%) with mild fatigue, 121 (52.8%) with moderate fatigue, and 14 (6.1%) with severe fatigue. Multivariate regression analysis showed that higher depression scores, aldosterone levels may increase the risk of CRF. Patients who are obese (Body mass index ≥ 28 kg/m2) may help to reduce the risk of CRF. Other contributing factors for increased levels of fatigue (p< 0.05) include being female, having anxiety, depression and high aldosterone levels. Conclusion The research suggested that CRF was a common symptom in cancer survivors and pay attention to these influencing factors may help to better identify patients susceptible to fatigue and provide long-term, targeted interventions.
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Affiliation(s)
- Shanshan Gu
- Oncology Department, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Yun Xu
- Oncology Department, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaoshu Zhu
- National Institute of Complementary Medicine (NICM) Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Anderson Lam
- National Institute of Complementary Medicine (NICM) Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Danhui Yi
- School of Statistics, Renmin University of China, Beijing, China
| | - Lutian Gong
- Oncology Department, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Jinghui Wang
- School of Beijing University of Chinese Medicine, Beijing, China
| | - Xinyu Guo
- School of Beijing University of Chinese Medicine, Beijing, China
| | - Li Fu
- Oncology Department, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Jiyan Shi
- School of Beijing University of Chinese Medicine, Beijing, China
| | - Feiye Wang
- Oncology Department, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Ketan Liu
- School of Statistics, Renmin University of China, Beijing, China
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Pang Y, Shi R, Chan L, Lu Y, Zhu D, Liu T, Yan M, Wang Y, Wang W. The combination of the HDAC1 inhibitor SAHA and doxorubicin has synergic efficacy in triple negative breast cancer in vivo. Pharmacol Res 2023; 196:106926. [PMID: 37716547 DOI: 10.1016/j.phrs.2023.106926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/13/2023] [Accepted: 09/13/2023] [Indexed: 09/18/2023]
Abstract
Vorinostat (SAHA) is a histone deacetylase inhibitor that exerts its effects through epigenetic regulation. Specifically, SAHA can inhibit the proliferation of triple-negative breast cancer (TNBC) cells alone or in combination with other chemotherapeutic agents. Doxorubicin (DOX), a traditional chemotherapeutic drug, exhibits a potent cytotoxic effect on cancer cells while also inducing strong toxic effects. In this study, we investigated the synergistic potential of these two drugs in combination against TNBC. Our results suggested that the combination of these two drugs could enhance the inhibitory effect on cancer cell proliferation, resulting in alterations in cell mitotic phase, and suppression of cancer cell stemness. Moreover, our in vivo study unveiled that when SAHA was combined with DOX, it not only exhibited an inhibitory effect on tumor metastasis but also played a role in regulating the immune microenvironment within tumors. Overall, the combination of DOX and SAHA presents a promising avenue for innovative combination chemotherapy in the context of TNBC.
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Affiliation(s)
- Yuheng Pang
- Department of Breast Surgery, Tumor Hospital of Harbin Medical University, Harbin, Heilongjiang, PR China; NHC Key Laboratory of Cell Transplantation, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, PR China
| | - Runze Shi
- Department of Breast Surgery, Tumor Hospital of Harbin Medical University, Harbin, Heilongjiang, PR China
| | - Liujia Chan
- College of Pharmaceutical Sciences, Capital Medical University, Beijing, PR China
| | - Yu Lu
- College of Pharmaceutical Sciences, Capital Medical University, Beijing, PR China
| | - Di Zhu
- College of Pharmaceutical Sciences, Capital Medical University, Beijing, PR China
| | - Tong Liu
- Department of Breast Surgery, Tumor Hospital of Harbin Medical University, Harbin, Heilongjiang, PR China; NHC Key Laboratory of Cell Transplantation, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, PR China
| | - Meisi Yan
- Pathology Teaching and Research Section, Basic Medical College of Harbin Medical University, Harbin, Heilongjiang, PR China; NHC Key Laboratory of Cell Transplantation, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, PR China.
| | - Yuji Wang
- College of Pharmaceutical Sciences, Capital Medical University, Beijing, PR China.
| | - Wenjing Wang
- Beijing Institute of Hepatology, Beijing YouAn Hospital, Capital Medical University, Beijing, PR China.
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Perrier J, Galin M, Denise P, Giffard B, Quarck G. Tackling Insomnia Symptoms through Vestibular Stimulation in Patients with Breast Cancer: A Perspective Paper. Cancers (Basel) 2023; 15:cancers15112904. [PMID: 37296867 DOI: 10.3390/cancers15112904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/05/2023] [Accepted: 05/09/2023] [Indexed: 06/12/2023] Open
Abstract
Insomnia symptoms are common among patients with breast cancer (BC; 20-70%) and are predictors of cancer progression and quality of life. Studies have highlighted sleep structure modifications, including increased awakenings and reduced sleep efficiency and total sleep time. Such modifications may result from circadian rhythm alterations consistently reported in this pathology and known as carcinogenic factors, including lower melatonin levels, a flattened diurnal cortisol pattern, and lower rest-activity rhythm amplitude and robustness. Cognitive behavioral therapy and physical activity are the most commonly used non-pharmacological interventions to counter insomnia difficulties in patients with BC. However, their effects on sleep structure remain unclear. Moreover, such approaches may be difficult to implement shortly after chemotherapy. Innovatively, vestibular stimulation would be particularly suited to tackling insomnia symptoms. Indeed, recent reports have shown that vestibular stimulation could resynchronize circadian rhythms and improve deep sleep in healthy volunteers. Moreover, vestibular dysfunction has been reported following chemotherapy. This perspective paper aims to support the evidence of using galvanic vestibular stimulation to resynchronize circadian rhythms and reduce insomnia symptoms in patients with BC, with beneficial effects on quality of life and, potentially, survival.
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Affiliation(s)
- Joy Perrier
- Neuropsychologie et Imagerie de la Mémoire Humaine U1077, EPHE, INSERM, CHU de Caen, GIP Cyceron, PSL Université, Normandie Univ, Université de Caen Normandie, 14000 Caen, France
| | - Melvin Galin
- Neuropsychologie et Imagerie de la Mémoire Humaine U1077, EPHE, INSERM, CHU de Caen, GIP Cyceron, PSL Université, Normandie Univ, Université de Caen Normandie, 14000 Caen, France
- COMETE U1075, INSERM, CYCERON, CHU de Caen, Normandie Univ, Université de Caen Normandie, 14000 Caen, France
| | - Pierre Denise
- COMETE U1075, INSERM, CYCERON, CHU de Caen, Normandie Univ, Université de Caen Normandie, 14000 Caen, France
| | - Bénédicte Giffard
- Neuropsychologie et Imagerie de la Mémoire Humaine U1077, EPHE, INSERM, CHU de Caen, GIP Cyceron, PSL Université, Normandie Univ, Université de Caen Normandie, 14000 Caen, France
| | - Gaëlle Quarck
- COMETE U1075, INSERM, CYCERON, CHU de Caen, Normandie Univ, Université de Caen Normandie, 14000 Caen, France
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Amidi A, Wu LM. Circadian disruption and cancer- and treatment-related symptoms. Front Oncol 2022; 12:1009064. [PMID: 36387255 PMCID: PMC9650229 DOI: 10.3389/fonc.2022.1009064] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 09/28/2022] [Indexed: 07/27/2023] Open
Abstract
Cancer patients experience a number of co-occurring side- and late-effects due to cancer and its treatment including fatigue, sleep difficulties, depressive symptoms, and cognitive impairment. These symptoms can impair quality of life and may persist long after treatment completion. Furthermore, they may exacerbate each other's intensity and development over time. The co-occurrence and interdependent nature of these symptoms suggests a possible shared underlying mechanism. Thus far, hypothesized mechanisms that have been purported to underlie these symptoms include disruptions to the immune and endocrine systems. Recently circadian rhythm disruption has emerged as a related pathophysiological mechanism underlying cancer- and cancer-treatment related symptoms. Circadian rhythms are endogenous biobehavioral cycles lasting approximately 24 hours in humans and generated by the circadian master clock - the hypothalamic suprachiasmatic nucleus. The suprachiasmatic nucleus orchestrates rhythmicity in a wide range of bodily functions including hormone levels, body temperature, immune response, and rest-activity behaviors. In this review, we describe four common approaches to the measurement of circadian rhythms, highlight key research findings on the presence of circadian disruption in cancer patients, and provide a review of the literature on associations between circadian rhythm disruption and cancer- and treatment-related symptoms. Implications for future research and interventions will be discussed.
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Affiliation(s)
- Ali Amidi
- Unit for Psycho-Oncology and Health Psychology, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
- Sleep and Circadian Psychology Research Group, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Lisa M. Wu
- Unit for Psycho-Oncology and Health Psychology, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
- Sleep and Circadian Psychology Research Group, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
- Aarhus Institute of Advanced Studies, Aarhus University, Aarhus, Denmark
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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Lambert M, Sabiston CM, Wrosch C, Brunet J. Behavioural, physical, and psychological predictors of cortisol and C-reactive protein in breast cancer survivors: A longitudinal study. Brain Behav Immun Health 2021; 10:100180. [PMID: 34589720 PMCID: PMC8474539 DOI: 10.1016/j.bbih.2020.100180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/26/2020] [Accepted: 11/28/2020] [Indexed: 12/05/2022] Open
Abstract
Background Breast cancer survivors (BCS) can exhibit a dysregulation of cortisol and elevated C-reactive protein (CRP) levels post-treatment, which increase the risk of diverse health outcomes. Certain behavioural, physical, and psychological variables may help to predict cortisol and CRP levels post-treatment. The aims of this study were to: (1) describe naturally occurring changes in absolute diurnal cortisol and CRP levels over a period of 1.5 years post-treatment among BCS, (2) assess if absolute diurnal cortisol and CRP levels change in tandem, and (3) assess behavioural, physical, and psychological variables as predictors of absolute diurnal cortisol levels and CRP levels. Methods Capillary blood and saliva samples were collected from 201 BCS, on average, 3.5 months post-treatment (T1) and again 3, 6, 9, and 12 months later (T2−T5). At each time point, five saliva samples were collected on two nonconsecutive days: at awakening, 30 min after awakening, 2:00 p.m., 4:00 p.m., and at bedtime. At each time point, participants also completed self-report questionnaires and wore an accelerometer for seven consecutive days. Data were analyzed using multilevel modeling. Results Absolute diurnal cortisol levels did not change significantly over time. CRP levels decreased across time points (Blinear = −0.31, p = .01), though the rate of decrease slowed over time (Bquadratic = 0.05, p = .03). Generally, greater sedentary time predicted higher overall absolute diurnal cortisol levels (B < 0.01, p = .01); whereas higher physical activity (B = −0.004, p < .01), lower body mass index (B = 0.10, p < .01), and lower health- and cancer-related stress (B = 0.24, p = .04) predicted lower overall CRP levels. Also, lower absolute diurnal cortisol levels were evident when participants engaged in more sedentary time, as compared to their own average sedentary time (B = −0.01, p < .01). Conclusions Results offer insight into the nature of change in diurnal cortisol and CRP levels among BCS from treatment completion onwards and offer clinical implications. Helping BCS manage their weight, reduce stress, increase physical activity participation, and decrease sedentary time as soon as possible after treatment may help to reduce physiological dysregulations, thereby lowering the risk of adverse health outcomes in this population. Further research investigating specific intervention parameters such as type, context, frequency, and intensity are warranted for the development of the most optimal interventions.
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Affiliation(s)
- M Lambert
- School of Psychology, University of Ottawa, ON, Canada
| | - C M Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - C Wrosch
- Department of Psychology, Concordia University, Montreal, Canada
| | - J Brunet
- School of Human Kinetics, University of Ottawa, Montpetit Hall, Room 339, Ottawa, ON K1N 6N5, Canada
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Lambert M, Sabiston CM, Wrosch C, Brunet J. An investigation into socio-demographic-, health-, and cancer-related factors associated with cortisol and C-reactive protein levels in breast cancer survivors: a longitudinal study. Breast Cancer 2020; 27:1096-1106. [PMID: 32488733 DOI: 10.1007/s12282-020-01113-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 05/16/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Breast cancer survivors (BCS) may exhibit dysregulated patterns of cortisol and C-reactive protein (CRP). The aims of this study were to describe BCS' cortisol and CRP levels over a 1-year period after treatment, and assess how levels relate to socio-demographic- (age, education level, marital status), health- (body mass index [BMI] category, menopausal status), and cancer-related factors (cancer stage, chemotherapy exposure, time since diagnosis). METHODS Participants (N = 201) provided data at 3 months post-treatment (T1) and again 3, 6, 9, and 12 months later (T2-T5). At T1, participants completed self-report questionnaires and had their weight and height measured by a trained technician. At T1-T5, they provided five saliva samples at awakening, 30 min after awakening, 2:00 pm, 4:00 pm, and before bedtime on two nonconsecutive days to measure diurnal cortisol, and provided capillary whole blood to measure CRP. Data were analyzed using repeated-measure analyses of variance (ANOVAs) and mixed-design ANOVAs. RESULTS Diurnal cortisol and CRP levels fluctuated over time. In univariate models, older age and post-menopausal status were associated with higher cortisol and CRP levels, higher cancer stage and chemotherapy were associated with lower cortisol levels, and higher BMI category was associated with higher CRP levels. In adjusted models, age was no longer associated with CRP levels and shorter time since diagnosis was significantly associated with higher CRP levels. CONCLUSIONS Socio-demographic-, health-, and cancer-related factors may help identify BCS at risk of physiological dysregulation who need intervention. Identifying modifiable factors associated with cortisol and CRP will inform cancer care interventions.
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Affiliation(s)
- M Lambert
- School of Psychology, University of Ottawa, Ontario, Canada
| | - C M Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - C Wrosch
- Department of Psychology, Concordia University, Montreal, Canada
| | - J Brunet
- School of Human Kinetics, University of Ottawa, Montpetit Hall, Room 339, Ottawa, ON, K1N 6N5, Canada.
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