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Stress and depression are associated with shorter survival in head and neck cancer patients
Date:4/28/2011

psychosocial questionnaire to complete prior to treatment, which required them to answer questions about social support, depression, and perceived stress. In addition, VEGF expression in tumor tissue obtained during surgery was evaluated using immunohistochemistrya process that helps detect the presence of specific proteins in cells or tissues.

"Our analysis indicated that higher levels of perceived stress and depressive symptoms were associated with greater VEGF expression in the tumor tissue of these patients" says Fang. Greater VEGF expression was, in turn, associated with shorter disease-free survival among patients.

The associations between psychosocial functioning and VEGF were strong among early-stage patients, but were less apparent among late-stage patients.

"It's possible that in early stage disease, psychosocial stress makes patients more susceptible to cancer-related death, while in patients with advanced disease, other factors become more important in determining outcome," says Miriam N. Lango, M.D., Medical Director of Speech Pathology Service and Attending Surgeon in Head and Neck Oncology at Fox Chase. "In patients with advanced cancers, psychosocial interventions may have less of an impact since these cancers are inherently more aggressive."

In the near-term, Fang and her colleagues hope to expand the study to look at a larger sample of patients and to incorporate other signaling pathways that are relevant to cancer, like EGFR, which researchers involved in Fox Chase's Keystone Program in Head and Neck Cancer are already exploring.

"The next step is to conduct a longitudinal study that would allow us to examine patient psychosocial functioning in conjunction with biomarkers of disease aggressiveness and survival from pre-treatment through post-treatment and beyond, which would give us a more complete picture of how these factors may contribute to patient outcomes," Carolyn adds.


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Contact: Frank Hoke
Franklin.Hoke@fccc.edu
215-728-2700
Fox Chase Cancer Center
Source:Eurekalert

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