Can Depression Reduce Chemotherapy Tolerability, Effectiveness in Advanced Lung Cancer?
Mental state can influence the effectiveness of cancer treatments.
Depression might reduce the effectiveness of cancer chemotherapy, researchers reported at the European Society for Medical Oncology (ESMO) Asia 2016 Congress in Singapore.1
The preliminary analysis found that depression is associated with lower circulating levels of a growth-factor protein called brain-derived neurotophic factor (BDNF) in patients with cancer — and that this might make those patients less able to withstand chemotherapy toxicities and likely to respond to chemotherapy.
"It is crucial doctors pay more attention to the mood and emotional state of patients,” emphasized lead study author Yufeng Wu, head of oncology, department of internal medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, China.
Dr Wu and colleagues sought to evaluate the association between depression and outcomes among 186 newly diagnosed patients with advanced lung cancer. Participants rated their depression levels and reported quality-of-life details at baseline (a day before treatment started).
Patients with metastatic disease were more depressed and this was associated with poorer chemotherapy tolerance, the team reported. Depression was associated with vomiting, reduced white blood cell counts, and extended hospitalizations. The causal relationships of these associations are not yet clear.
Circulating BDNF levels were lower among depressed patients and were associated with chemotherapy's tumor cytotoxicity, the researchers claimed.
More research is needed to understand the findings and their clinical implications.
"Our aim now is to prescribe drugs such as fluoxetine to depressed patients and study their sensitivity to chemotherapy," said Dr Wu.
1. European Society for Medical Oncology. Press release: ESMO Asia 2016 Congress: Depressed patients are less responsive to chemotherapy. http://www.esmo.org/Conferences/ESMO-Asia-2016-Congress/News/Depressed-Patients-Are-Less-Responsive-to-Chemotherapy. December 18, 2016.