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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Pre-op Treatments Boost Survival for Esophageal Cancer Patients: Study

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Fitness May Boost Survival for Women With Breast Cancer

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Exercise May Boost Survival in Breast, Colon Cancer Patients

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Hispanics Seem to Have Better Odds of Lung Cancer Survival

HealthDay – 1 hr 24 mins ago MONDAY, April 23 (HealthDay News) -- Hispanic people with lung cancer tend to live longer than white or black people with the disease, according to a new study.

Researchers say Hispanics' increased likelihood of survival may be due to genetic factors or environmental advantages, such as lower rates of tobacco use.

In the study, the researchers examined diagnosis and survival data on cancer patients from a national database that pooled information from U.S. cancer registries.

They identified 172,000 adults diagnosed with any stage of the most common form of lung cancer, known as non-small cell lung cancer, between 1988 and 2007. Of these patients, Hispanics had a 15 percent lower risk of death during the study than whites. This was true for both U.S.- and foreign-born Hispanics.

The study, published online in the journal Cancer, pointed out that Hispanics tend to have better odds of survival despite facing more obstacles to health care and higher rates of poverty than other groups.

"This is important because it shows that our findings are indicative of the Hispanic population in general and not specific to specific groups of Hispanics," lead study author Ali Saeed, an M.D./Ph.D. candidate at University of Miami Miller School of Medicine, said in a journal news release.

The study's authors added that the white patients who were studied had a slightly higher likelihood of survival than those who were black. Hispanics were more likely to be diagnosed with a less serious form of lung cancer, known as bronchioalveolar carcinoma.

"Our findings will motivate researchers and physicians to understand why Hispanics have more favorable outcomes and may shed light on potential environmental factors and/or genetic factors that can explain our observations," said Saeed. "For instance, the fact that Hispanics developed higher frequencies of bronchioalveolar carcinoma could be due to genetic predispositions and/or their lower smoking rates."

More information

The U.S. National Library of Medicine has more about lung cancer.

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Immune-Based Drug Combo Might Extend Cancer Survival

HealthDay – 1 hr 44 mins ago MONDAY, April 2 (HealthDay News) -- Cancer patients who receive a combination of low-dose interleukin-2 and retinoic acid after conventional therapy seem to live longer than those who don't get the combination.

These new study findings, slated for presentation this week at the annual meeting of the American Association for Cancer Research in Chicago, were seen across individuals with many different forms of advanced malignancies, including breast, lung and colon cancers.

Retinoic acid is derived from vitamin A. Interleukin-2, a compound that fortifies the immune system, is approved at high doses to treat "metastatic" melanoma and kidney cancer. Metastatic means that a cancer has spread.

The study showed that "these biological compounds may work at low doses. Bigger doses are not always better," said lead author Dr. Francesco Recchia, director of the oncology department at Civilian Hospital in Avezzano, Italy.

Recchia stumbled upon the possibility of using low-dose interleukin-2 (IL-2) when he switched a patient with metastatic melanoma who didn't tolerate high doses to a lower dose, and the patient had an extended response to the therapy.

This study involved 500 patients who had already responded well to chemotherapy. They had a variety of cancers, including ovarian, lung, colon, stomach, kidney, melanoma, breast and pancreatic.

Participants gave themselves the interleukin-retinoic acid duo five days a week for three weeks, then took a break of one week followed by another three weeks -- for five years or until the cancer came back.

Individuals who pursued the maintenance therapy did live longer, the researchers found. About 43 percent of breast cancer patients were alive after five years, versus an expected average survival of about only one-quarter of patients.

Similarly, about 26 percent of lung cancer patients were alive after five years versus about 4 percent expected, nearly 44 percent of those with colorectal cancer were alive as compared with about 12 percent in an average population, and 23 percent of kidney cancer patients were alive versus 11 percent expected.

After 15 years, about 33 percent of patients were alive without having had a recurrence and 37 percent overall were alive, the investigators reported.

"This regimen works by increasing immune response," Recchia explained.

In this case, immune response consisted of an increase in the number of natural killer cells, which are primed to attack tumors, and a decrease in vascular endothelial growth factor, which would normally prompt a tumor to spread.

There were no serious side effects, Recchia said, and the therapy's cost is about $300 a week.

While IL-2 activates the immune system, retinoic acid is an angiogenic agent, meaning it reduces blood supply to tumors, explained Dr. Michael Atkins, deputy director of the Georgetown Lombardi Comprehensive Cancer Center in Washington, D.C. He was not involved with the study.

The results are "provocative," Atkins said, but one problem is that all the patients had already benefited from chemotherapy so it's unclear if they would have done well without the immune therapy, he added.

A bigger trial of patients randomly assigned to receive treatment is now starting in Siena, Italy, in breast cancer patients, Recchia said.

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

For more on interleukin-2 and other biological therapies, visit the U.S. National Cancer Institute.

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Body mass index not linked to post-surgical complications, survival in esophageal adenocarcinoma, study suggests

ScienceDaily (Mar. 28, 2012) — Researchers at Moffitt Cancer Center in Tampa, Fla., have found -- contrary to previous studies linking inferior outcomes in patients with gastrointestinal malignancies to higher body mass index (BMI) -- that in their study of BMI and negative outcomes, there was no such link. They concluded that BMI was not associated with either surgical complications or esophageal cancer patient survival.

See Also:Health & MedicineObesityDiet and Weight LossBreast CancerColon CancerDiseases and ConditionsToday's HealthcareReferenceBody mass indexOverweightNutrition and pregnancyObesity

Their study was published in the current online issue of the Journal of Gastrointestinal Surgery, published by the Society for Surgery of the Alimentary Tract.

"The incidence of esophageal cancer in North America is rising," said study co-author Kenneth L. Meredith, M.D., assistant member at Moffitt and chief of the Esophagogastric Oncology Section. "Corresponding to that rise, there has been a dramatic rise in overweight and obese people as defined by the World Health Organization's guidelines indicating those having a BMI of 25 to 29.9 as being overweight and those who are obese as having a BMI of over 30."

According to the researchers, the increase in obesity and the increase in esophageal cancer has been linked, as has obesity been similarly linked with other kinds of cancers. Obesity is recognized as a risk factor for esophageal cancer. What remains in question, however, is whether a high BMI affects post-surgical complications and overall survival among esophageal cancer patients who have been treated with chemotherapy, radiation and surgery.

"The correlation of obesity with surgical risks and postoperative survival is more important given the rise in obesity rates, yet more clarity on potential correlation is needed," said Meredith. "The literature shows mixed study results."

In their paper, the authors cited a number of studies that correlated lower BMI with better outcomes for a variety of cancers as well as studies that found no prognostic significance correlating higher BMI with poorer outcomes.

Because of the prevailing belief that patients with a high BMI tend to have more surgical complications as compared to normal weight patients, the Moffitt researchers examined esophageal cancer patient data on BMI for links to surgical risk and postoperative survival, especially for those patients with high BMI.

Their study included 303 esophageal cancer patients treated with chemotherapy, radiation and surgery who were stratified by their BMI to include those with BMIs less than 25 to greater than 35. The only demographic differences were in gender, with a higher proportion of males in the BMI 25 to 30 group.

"Our study demonstrated no significant differences in overall survival or disease-free survival in relation to BMI for patients with esophageal adenocarcinoma who underwent surgery after prior treatment with chemotherapy and radiation," said Meredith. "Additionally, there were no differences in perioperative complications or mortality associated with BMI. In short, our data failed to demonstrate a link between BMI and surgical outcome."

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