Interleukin-1 may link helplessness-hopelessness with cancer progression: a proposed model

Stress, Inflammation and Cancer Prognosis: New Evidence-Based Effective Treatments

This article introduces the general model of stress, coping and adaptation applied to cancer, and biological mechanisms mediating psychological factors and cancer prognosis. The role of the vagus nerve as a possible bridge and therapeutic target in psycho-oncology is reviewed. Finally, the effects of brief psychological interventions (e.g., stress management) on cancer prognosis are presented. Psycho-oncology education and practice need to shift to a more evidence-based proactive approach, to help cancer patients adapt and possibly improve their quality and quantity of life.

Vagal nerve activity predicts overall survival in metastatic pancreatic cancer, mediated by inflammation

Recent research findings suggest neuro-modulation of tumors. Finding new modifiable prognostic factors paves the way for additional treatments, which is crucial in advanced cancer, particularly pancreatic cancer. This study examined the relationship between vagal nerve activity, indexed by heart rate variability (HRV), and overall survival (OS) in patients (N=272) with advanced pancreatic cancer. A "historical prospective" design was employed, where vagal activity and other confounders were retroactively obtained from medical charts at diagnosis, and subsequent OS was examined. HRV was obtained from 10 sec ECGs near diagnosis. Levels of C-reactive protein (CRP) were measured as an inflammatory marker. OS and survival date were obtained from medical charts and the Belgian national registry. Patients with high HRV (>20 msec) survived on average more than double the days (133.5) than those with low HRV (64.0). In a multivariate cox regression, higher initial HRV was significantly correlated with lower risk of death, independent of confounders including age and cancer treatments. This relationship was statistically mediated (accounted for) by CRP levels. Importantly, in patients who lived up to one month from diagnosis only, HRV was unrelated to CRP, while in patients surviving longer, HRV was significantly inversely related to CRP (r=-0.20, p<0.05). These results are in line with possible vagal nerve protection in a fatal cancer, and propose that the mechanism may involve neuroimmuno-modulation. Future studies must test whether vagal nerve activation may help patients with advanced cancers.

Psychosocial factors, biological mediators, and cancer prognosis: a new look at an old story

PURPOSE OF REVIEW

The present article briefly reviews the prognostic role of psychosocial factors in cancer and concentrates on biological markers that may mediate such relationships. We focus on specific markers that show promising mediating roles.

RECENT FINDINGS

The article reviews the prognostic role of psychosocial factors as shown in longitudinal studies and in previous reviews. We present the general stress response and its relevance to cancer progression. The main focus of the article is on the prognostic roles of specific biomarkers that had to meet three criteria for being accepted as biomarkers - being related to a psychosocial factor at the level of the brain, the circulation, and the tissue/cellular level. We review studies supporting the mediating roles of neurohormones and neurotransmitters (e.g., cortisol, norepinephrine), the vagal nerve and inflammation, interleukin-1, DNA damage, and the hormone oxytocin.

SUMMARY

These biomarkers may mediate the relationships between certain psychosocial factors (e.g., hopelessness, social support) and cancer progression. Future studies should test the effects of altering such biomarkers on the prognosis of patients scoring high/low on their associated psychosocial factors. Clinical implications that need to be tested are provided.

Neural-endocrine-immune complex in the central modulation of tumorigenesis: facts, assumptions, and hypotheses

For the precise coordination of systemic functions, the nervous system uses a variety of peripherally and centrally localized receptors, which transmit information from internal and external environments to the central nervous system. Tight interconnections between the immune, nervous, and endocrine systems provide a base for monitoring and consequent modulation of immune system functions by the brain and vice versa. The immune system plays an important role in tumorigenesis. On the basis of rich interconnections between the immune, nervous and endocrine systems, the possibility that the brain may be informed about tumorigenesis is discussed in this review article. Moreover, the eventual modulation of tumorigenesis by central nervous system is also considered. Prospective consequences of the interactions between tumor and brain for diagnosis and therapy of cancer are emphasized.

The relation between psychological factors and DNA-damage: a critical review

Investigating relations between psychological factors and DNA-damage can contribute to understanding how psychological factors affect the etiology and prognosis of relevant diseases (e.g., cancer, heart disease) at the fundamental level of mutated cells. This article critically reviews 21 studies in animals and humans testing relations between psychological factors and DNA-damage. After providing a biological background, we critically review each study. The findings in humans are mapped onto a model of stress, coping and health. These studies demonstrate causal relations between acute stressors and DNA-damage in animals and significant correlations between psychological factors (e.g., depression, coping) and DNA-damage in humans, which are moderated by gender. Possible mechanisms for these relations, limitations of studies, clinical implications and suggestions for future research are provided.