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慢性应激与癌症的相互作用:病理生理学及对综合治疗的启示

The Interplay of Chronic Stress and Cancer: Pathophysiology and Implications for Integrated Care.

作者信息

Talukdar Joyeeta, Choudhary Hemant, Bhatnagar Sushma, Pandit Anuja, Mishra Ashwani Kumar, Karmakar Subhradip, Sharan Pratap

机构信息

Department of Bio-Chemistry, All India Institute of Medical Sciences, New Delhi, India.

Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.

出版信息

Cancer Rep (Hoboken). 2025 May;8(5):e70143. doi: 10.1002/cnr2.70143.

Abstract

BACKGROUND

Cancer-associated depression is a multifaceted condition that arises from the interplay of biological, psychological, and social factors in individuals diagnosed with cancer. Understanding this condition involves exploring how cancer and its treatments can precipitate depressive symptoms and the mechanisms behind this association. Chronic stress, inflammation, and immunological responses play a crucial role in the development of both cancer and depression. The objective of this review is to describe and synthesize information on the complex interactions between chronic stress, inflammation, immunological responses, and cancer development. Additionally, it aims to review existing evidence regarding mechanisms such as neurotransmitter imbalances, structural brain changes, and genetic predispositions as key contributors to depression in cancer patients.

RECENT FINDINGS

A comprehensive literature search on Cancer-associated Depression was conducted in electronic databases, including APA PsycINFO, Medline, Google Scholar, Embase, PubMed, Scopus, and Web of Science. The research focused on understanding the potential relationship between stress-induced depression and cancer by examining neurochemical, anatomical, immunological, genetic, and psychological changes. The findings revealed a compilation of both quantitative and qualitative studies on depression in cancer patients. Evidence suggested a potential link between cancer-induced stress and depression, with increased levels of proinflammatory cytokines (such as IL-6) and dysregulation of neurotransmitters, including serotonin, contributing to the onset of depression. Furthermore, studies indicated that antidepressants, along with psychological interventions, were effective in managing depression among cancer patients.

CONCLUSION

This narrative review provides insights into the importance of integrating oncology and mental health services to address the psychosocial needs of cancer patients. Future research should focus on the bidirectional interactions between stress and cancer, aiming to improve cancer care by incorporating mental health support. Addressing the mental health aspects of cancer treatment can significantly enhance patient outcomes and overall quality of life.

摘要

背景

癌症相关抑郁是一种多方面的状况,源于被诊断患有癌症的个体中生物、心理和社会因素的相互作用。了解这种状况需要探究癌症及其治疗如何引发抑郁症状以及这种关联背后的机制。慢性应激、炎症和免疫反应在癌症和抑郁的发展中都起着关键作用。本综述的目的是描述和综合关于慢性应激、炎症、免疫反应与癌症发展之间复杂相互作用的信息。此外,其旨在回顾有关神经递质失衡、脑结构变化和遗传易感性等机制的现有证据,这些机制是癌症患者抑郁的关键促成因素。

最新发现

在包括美国心理学会心理学文摘数据库(APA PsycINFO)、医学索引数据库(Medline)、谷歌学术、荷兰医学文摘数据库(Embase)、美国国立医学图书馆生物医学数据库(PubMed)、Scopus和科学引文索引数据库(Web of Science)在内的电子数据库中,对癌症相关抑郁进行了全面的文献检索。该研究通过检查神经化学、解剖学、免疫学、遗传学和心理变化,重点了解应激诱导的抑郁与癌症之间的潜在关系。研究结果揭示了一系列关于癌症患者抑郁的定量和定性研究。证据表明癌症诱发的应激与抑郁之间可能存在联系,促炎细胞因子(如白细胞介素 - 6)水平升高以及包括血清素在内的神经递质失调会导致抑郁发作。此外,研究表明抗抑郁药与心理干预一起,对管理癌症患者的抑郁有效。

结论

本叙述性综述深入探讨了整合肿瘤学和心理健康服务以满足癌症患者心理社会需求的重要性。未来的研究应关注应激与癌症之间的双向相互作用,旨在通过纳入心理健康支持来改善癌症护理。解决癌症治疗中的心理健康问题可显著提高患者的治疗效果和整体生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6155/12087007/d041f64aadae/CNR2-8-e70143-g001.jpg

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