Depression Could Shorten Cancer Survival, Study Suggests

HealthDay – 2 hrs 57 mins ago WEDNESDAY, Aug. 1 (HealthDay News) -- Symptoms of depression are linked to shorter survival times among cancer patients, according to a new study.

The link may be attributed to abnormal stress hormone regulation and inflammatory gene expression, researchers from the University of Texas M.D. Anderson Cancer Center reported in the Aug. 1 edition of PLoS ONE.

"Our findings, and those of others, suggest that mental health and social well-being can affect biological processes, which influence cancer-related outcomes," Lorenzo Cohen, a professor in the center's departments of general oncology and behavioral science, and director of the Integrative Medicine Program, said in a university news release.

The findings "also suggest that screening for mental health should be part of standard care because there are well-accepted ways of helping people manage distress, even in the face of a life-threatening illness," Cohen added.

In conducting the study, the researchers analyzed surveys completed over a five-year period by 217 patients newly diagnosed with kidney cancer that had spread. The participants answered questions about how religious and spiritual they were. They were also asked about their symptoms of depression, social support, quality of life and coping skills.

The patients also provided blood samples as well as five saliva samples daily for three days. The researchers used the saliva samples to track changes in the patients' levels of cortisol, a stress hormone that is usually high in the morning before dropping throughout the day.

At the time of the analysis, 64 percent of the patients had died. The average amount of time these patients survived after being diagnosed was 1.8 years.

Overall, the study revealed that 23 percent of patients were clinically depressed. Even after taking other disease-related risk factors into account, the investigators noted that depression was associated with shorter survival time. Moreover, the study showed that higher than usual cortisol levels throughout the day were also linked to shorter survival among the cancer patients.

Using tissue samples from 15 of the patients with the most significant symptoms of depression and 15 samples from the patients with the mildest forms of depression, the researchers then conducted whole-genome profiling to determine if the depression is linked to increased risk of death for cancer patients.

They found specific signaling pathways, which play a key role in regulating cell inflammation, were expressed at increased levels in patients with depression. The study authors concluded the link between patients' mental health and survival time is associated with inflammatory gene regulation.

"Our findings indicate that we're now able to understand some of the possible biological pathways that explain the association between depression and survival," Cohen noted.

The researchers noted that the study was limited by the fact that it's difficult to determine if patients' stress or symptoms of depression are influenced by other factors or were present before their cancer diagnosis. While the study uncovered an association between depression and cancer survival, it did not prove a cause-and-effect relationship.

More research is needed to investigate if the treatment of depression can improve survival time among cancer patients with mild, moderate or severe mood disorders, the authors added.

More information

The U.S. National Cancer Institute has more about cancer and depression.

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Loneliness, Living Alone Might Shorten Life

HealthDay – 4 hrs ago MONDAY, June 18 (HealthDay News) -- They say that one is the loneliest number, but it might also be the deadliest.

Two new studies suggest that living alone or being lonely can raise a person's risk of dying from heart disease or any cause.

In one study, people with heart disease who lived alone were more likely to die than their counterparts who did not. A second report showed that people aged 60 or older were at an increased risk of functional decline and/or death if they felt left out, isolated or reported a lack of companionship. Both studies were released online June 18 in the Archives of Internal Medicine.

"Living alone may be a risk factor for a bad outcome," said study author Dr. Deepak Bhatt, director of the integrated cardiovascular intervention program at Brigham and Women's Hospital in Boston. The study only looked at whether the individual lived alone. Researchers did not ask whether this was a choice or if they had lost a partner or had a pet.

But, he said, a person can be lonely and not live alone, and live alone and not be lonely. Still, living alone, regardless of the reason, should be a red flag for doctors to ask more questions.

There are many reasons that living alone or feeling lonely could increase risk for health problems and death. "If you had a heart attack and run out of medication and don't fill your prescription, you will run into trouble," he said. "Spouses and children can run out and get medications for you, and then you are less likely to get into trouble."

What's more, someone who is lonely may be more likely to be depressed, he said. This would make them less likely to take care of themselves, which could increase their risk of dying from any cause. Bottom line is that "doctors should get a good social history," Bhatt said.

In the second report, Dr. Carla Perissinotto, of the University of California, San Francisco, found that loneliness was associated with an increased risk of death during the study's six-year follow-up period. What's more, loneliness was also associated with functional decline.

Taken together, "the studies show that social isolation is associated with cardiovascular mortality in people with heart disease," said Dr. Nieca Goldberg, a clinical associate professor in the department of medicine at the Leon H. Carney Division of Cardiology at NYU Langone Medical Center and medical director at the Joan H. Tisch Center for Women's Health in New York City.

It's all about a patient's support system, she said. Health care providers need to try to identify a support system -- or lack thereof -- before a person with heart disease is released from the hospital. "A support system doesn't have to be an individual, it can be a place of worship or senior's group," Goldberg noted.

While the study uncovered an association between being lonely and an increased risk for health problems and death, it did not prove a cause-and-effect relationship.

More Information

Learn about other risks for heart disease at the American Heart Association.

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Interpreters may help shorten hospital stays

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