Keywords
cancer
tumors
tumor risk
epigenetics
How to Cite
Abstract
The integration between medicine and psychology is generally accepted, but in particular it is crucial to understand and treat cancer. Today it is known that, in addition to the genomic alterations that may undoubtedly be present, epigenetic alterations play a fundamental role.
The purpose of this article is to discuss recent evidence indicating that psychological distress resulting from a cancer diagnosis worsens prognosis if not adequately treated. Unfortunately, most of the people with cancer do not receive adequate and competent psychological help but, as frequently happens, just anxiolytics and antidepressants, whose effectiveness, in these cases, is questionable due to the risks of negative effects on the brain (cognitive deficits) and in the immune system.
Chronic stress and trauma imprint an epigenetic signature on the brain and immune system (IS) cells, which induce chronic neuroinflammation and immune dysregulation. Sustained stimulation of the stress system induces a "conserved transcriptional response to adversity (CTRA)" in peripheral immune cells. This is manifested by increased expression of pro-inflammatory genes (including IL-1β, IL-6 and TNF-α) and decreased expression of genes that modulate the synthesis of antibodies and antiviral molecules (type 1 immune circuit). Thus, the inactivation of the type 1 immune circuit exposes people to a greater risk of developing cancer and viral infections.
There is well-founded evidence of the relationship between stress and cancer from animal research. These results show the participation of the immune system in the control of initiation, growth and metastasis, disturbing the response of cytotoxic lymphocytes and NK cells, important members of the Type 1 circuit.
There is also growing evidence from human studies being the best established those coming from studies in the post-diagnosis phase. As it will be discussed, it has been shown that women with adequate social integration have better survival after colorectal cancer diagnosis. In addition several meta-analyses link depression, loneliness and social isolation with a reduced survival rate of cancer patients.
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