Biomedical researchers only shallowly understand the interplay between emotional and physical health. Now University of Arizona psychiatry professor Karen Weihs is going deeper, supported by a $3.7 million grant from the National Cancer Institute.
Dr. Weihs, a physician and the medical director of psychosocial oncology for the Arizona Cancer Center, will use the grant, announced April 24, to enroll 450 women newly diagnosed with breast cancer in a study of the biologic, psychological, and social characteristics that can help patients avoid developing depression. Recruitment for the study will begin next year.
“We are particularly interested in differences in the overall stress of these patients’ lives and the ways they cope with the emotional turmoil of the first year after breast cancer,” Dr. Weihs said.
“Our patients will be assessed for genetic factors that may combine with stress to increase the risk for depression,” she added. Additionally, she will examine “how close relationships may buffer the effects of stress.”
Some ties between cancer and depression seem self-evident. Over the first two years following diagnosis, 13 percent of individuals diagnosed with cancer suffer significant depressive symptoms, an incidence 3.55 times higher than non-diagnosed individuals; that seems natural, given the typical shock of diagnosis and fear about prognosis.
But Dr. Weihs sees greater nuance. Past research has shown that patients with cancer have a higher risk of developing a major depressive disorder than patients with other major illnesses, like heart disease, that are likewise often discovered in abrupt, traumatic fashion. And preexisting depression, another study showed, has a significant relationship to mortality among breast cancer patients, increasing the risk of death by 42 percent.
At the biochemical level, Dr. Weihs noted at a 2005 symposium sponsored by UA, additional complexity appears in the cancer-depression relationship. One characteristic of pancreatic cancer is a flood of cytokines–signaling molecules that stimulate immune response–and depressed cancer patients tend to have much higher cytokine levels than non-depressed patients. And some cancer therapeutics, such as procarbazine, appear to suppress dopamine production; the drugs tomaxafin and interferon-[alpha] are linked to higher depression rates among patients.
Teasing out pharmacologic contributors to and inhibitors of depression in breast cancer patients may provide one of the best avenues for increasing cancer patients’ long-term survival rates and lowering the cost of their care. At the same time, Dr. Weihs will be studying decidedly lower-tech factors, including patients’ social support systems. One recent study, for instance, found that socially isolated women diagnosed with breast cancer had a 66 percent higher overall mortality rate than socially integrated patients, and were more than twice as likely to die of breast cancer specifically.
For more information:
University of Arizona media release, 04/24/2009