Vascular endothelial growth factor and social support in patients with ovarian carcinoma

Abstract

BACKGROUND The modulation of immunologic activities relevant to cancer by behavioral factors, such as stress, depression, and social support, is well documented. However, associations of behavioral factors with cytokines involved in tumor angiogenesis have not been studied. Vascular endothelial growth factor (VEGF) is a key cytokine that is capable of stimulating tumor angiogenesis, and it has been associated with poorer survival in patients with ovarian carcinoma. VEGF is modulated by a variety of behaviorally sensitive factors, including sympathetic activation. This study examined relationships of social support and depressive symptoms with VEGF levels in preoperative patients with ovarian carcinoma. METHODS Twenty‐four women with ovarian carcinoma and 5 women with benign pelvic masses were recruited at the presurgical clinic visit, received psychosocial surveys, including the Functional Assessment of Cancer Therapy (Quality of Life) survey and the Profile of Mood States, and a blood draw. Serum VEGF levels were assessed by enzyme‐linked immunosorbent assay. Analyses controlled for disease stage. RESULTS Women with ovarian carcinoma who reported higher levels of social well being had lower levels of VEGF (P = 0.005). Greater support from friends and neighbors (P = 0.005) and less distance from friends (P = 0.04) were facets of social well being that were associated with lower VEGF levels. Individuals who reported greater helplessness (P = 0.03) or worthlessness (P = 0.08) had higher VEGF levels, but depression as a whole (P > 0.50) was not related to VEGF levels. CONCLUSIONS Higher levels of social well being were correlated with lower VEGF levels in presurgical patients with ovarian carcinoma. These findings suggest a possible mechanism by which poor social support may be associated with disease progression. Further study of these relations may demonstrate novel pathways relating biobehavioral factors to tumor growth and disease progression. Cancer 2002;95:808–15. © 2002 American Cancer Society. DOI 10.1002/cncr.10739

The Neuroendocrine Impact of Chronic Stress on Cancer

“…36 We have previously reported that higher levels of social support were correlated with lower VEGF levels in serum from presurgical patients with ovarian carcinoma providing a possible mechanism by which poor social support may be associated with disease progression. 37 We have also demonstrated that VEGF production by ovarian cancer cell lines was enhanced by stress hormones such as norepinephrine, epinephrine, and isoproterenol in vitro and blocked by the b-antagonist propranolol. 38 Based on our previous studies, we sought to elucidate whether chronic stress and the associated increase in sympathetic nervous system activity had a causal effect on growth and metastasis of ovarian cancer in vivo.…”

Psychological distress and its correlates in ovarian cancer: a systematic review

“…The relationship between levels of distress and immune factors was assessed in three good studies [18,23,24]. Costanzo et al [18] found that a history of depression and increased depressed mood were associated with higher levels of interleukin-6 in ascitic fluid.…”

“…Costanzo et al [18] found that a history of depression and increased depressed mood were associated with higher levels of interleukin-6 in ascitic fluid. Lutgendorf et al [23] found that higher levels of helplessness were associated with higher levels of vascular endothelial growth factor, a pro-angiogenic factor, which is associated with poorer survival. Lutgendorf et al [24] found that increased levels of distress were associated with lower levels of natural killer cells in tumour-infiltrating lymphocytes.…”

Neuroendocrine influences on cancer biology

“…A continuous infusion of propranolol abrogated the effects of stress on tumor burden and pattern of disease; therefore, confirming the importance of beta-adrenergic receptors on ovarian cancer cells in an in vivo model. Clinical studies have also shown a correlation between higher levels of social support and lower serum VEGF levels in ovarian cancer patients [47].…”