Psychologic Distress Is Associated with Cancer-Specific Mortality among Patients with Cervical Cancer

Abstract

Emerging evidence suggests a role of psychologic factors in the progression of different cancer types. However, it is unclear whether psychologic distress around the time of diagnosis of invasive cervical cancer places patients at a higher risk of cancer-specific mortality, independently of tumor characteristics and treatment modalities. We conducted a nationwide cohort study, including 4,245 patients with newly diagnosed cervical cancer during 2002-2011 in Sweden. Psychologic distress was indicated by a clinical diagnosis of depression, anxiety, or stress reaction and adjustment disorders, or the experience of a stressful life event, including death or severe illness of a family member, divorce, or between jobs, from one year before cancer diagnosis and onwards. We calculated the HRs of cancer-specific mortality among the patients exposed to psychologic distress, compared with unexposed patients, controlling for socioeconomic characteristics and other known prognostic indicators such as tumor and treatment characteristics. We found that patients exposed to psychologic distress had an increased risk of cancer-specific mortality (HR 1.33; 95% CI, 1.14-1.54). The association was primarily driven by distress experienced within one year before or after diagnosis (HR 1.30; 95% CI, 1.11-1.52), but not thereafter (HR 1.12; 95% CI, 0.84-1.49). In summary, our study shows that psychiatric disorders and stressful life events around cancer diagnosis are associated with increased cancer-specific mortality among patients with cervical cancer, independent of tumor characteristics and treatment modality. Significance: These findings support the integration of psychologic screening and intervention in the clinical management of patients with cervical cancer, particularly around the time of cancer diagnosis.

The Netrin-1-Neogenin-1 signaling axis controls neuroblastoma cell migration via integrin-β1 and focal adhesion kinase activation

“…In our analysis, NTN1 is expressed in the NB microenvironment. NTN1 is being secreted by the stroma and vessels of the NB primary tumors, corroborating prior literature pointing to an expression in lung and colon tumor stromal cells [39] . NTN1, being a secreted factor, is present in multiple tissues.…”

“…NEO1 has several ligands, including NTN1, which is the best-characterized member of the NTN laminin-related group composed by NTNs 1-4. Nowadays, there is a growing collection of information regarding the different biological roles that NTN1 displays in a variety of cancer types [38,39]. However, the signaling pathway that is activated downstream of NTN1 is an issue that remains to be resolved [40].…”

“…NTN1, although expressed by tumor cells, is mostly located either in adjacent endothelial cells or stroma, suggesting a relevant contribution to this pathology acting as chemotactic molecule. Importantly, NTN1 recently is upregulated in cancer-associated fibroblasts, modulating tumor plasticity [39]. Therefore, it is relevant to consider the tumoral/stromal/endothelial niche as being essential to sustain tumor growth and metastasis.…”

‘5 Minutes Mindful Breathing’ Smartphone Application for Reduction of Perceived Distress: A Pilot Study

“…An align ranked transformation method in ARTool was used to transform the non-normal data [7]. The data was then analyed using mixed ANOVA with groups (control versus intervention) as a between-subjects factor and time (pre and post) as a within-subject factor.…”

Sustained Adrenergic Activation of YAP1 Induces Anoikis Resistance in Cervical Cancer Cells

“…A substantial number of studies have established an important role for biobehavioral stress factors in cancer progression (Antoni and Dhabhar, 2019;Lu et al, 2019;Umamaheswaran et al, 2018). Environmental and psychosocial processes initiate a cascade of signaling in both the central and peripheral nervous systems, which trigger fight-or-flight stress responses and release of stress-related mediators including catecholamines (norepinephrine [NE] and epinephrine), cortisol, and other neurotransmitters via the hypothalamic-pituitary-adrenocortical (HPA) axis or the sympathetic nervous system (SNS) (Antoni et al, 2006).…”