stress, anxiety and depression reduce the effectiveness of immunotherapy – WWN

stress, anxiety and depression reduce the effectiveness of immunotherapy – WWN


Of Vera Martinella

A new study indicates that cancer not only feeds on negative emotions, but “exploits” them to protect itself from attacks by the immune system. Thus it can weaken treatment

Can stress trigger cancers? The relationship between the psychological state of people, healthy or already suffering from cancer, and the onset or evolution of a neoplastic disease is a complicated one. Several studies indicate that stress might facilitate the growth of some types of cancer and also the development of metastases. New evidence comes from research conducted by the Netherlands Cancer Institute in Amsterdam and recently published in the magazine Nature Medicine
the results of which were recently discussed in Naples during the «Immunotherapy and Melanoma Bridge» conference.

The hormones that nourish the neoplasm

To date there is no scientific evidence that stress causes tumorsbut it’s important for cancer patients to get it too psychological support, which helps them before, during and after treatment. «The study by Dutch colleagues clearly confirms this the existence of a close link between the emotional and psychological state of a patient with cancer and the immune responseeven when “enhanced” by specific immunotherapy treatments – he comments Paolo Ascierto, president of the conference and director of the Department of Melanoma Oncology, Oncology Immunotherapy and Innovative Therapies of theNational Cancer Institute IRCCS Pascale Foundation of Naples —. Stress can promote the growth and resilience of the tumor, both through the production of a series of hormones (for example cortisol) that “nourish” it, and by promoting the creation of an advantageous micro-environment for the proliferation of metastases and both “weakening” and “corrupting” the cells of the immune system. Psychological support from the beginning of the treatment process can therefore have a triple function: on the one hand can improve the patient’s quality of lifeon the other hand it can reduce the “nourishment” of the neoplasm and on the other still support and protect the response to immunotherapy treatments».

The Dutch study on melanoma

In short, cancer not only feeds on negative emotions, but also “exploits” them to protect itself from attacks by the immune system. That’s why stress, anxiety and depression can compromise the outcome of immunotherapy treatments, making them less effective. According to the most recent statistics half of the patients suffer from psychological distress, but in Italy seven out of ten patients do not receive help. In the Dutch research, the data of approximately 90 patients among those who took part in the PRADO project were analysed, a study which indicates the usefulness of neoadjuvant immunotherapy, i.e. administered before surgery, in patients with melanoma. At the start of the study all participants completed a questionnaire designed to assess quality of life, in order to identify those who presented emotional distress already before therapy based on immune checkpoint inhibitors, that is, drugs aimed at the “brakes” that prevent the immune system from effectively attacking the tumor. The patients were then followed for approximately 28 months. «Our results showed that emotional distress can negatively influence the immune response against the tumor – he explains Christian U. Blank, author of the study —. In particular, patients with emotional distress present before neoadjuvant immunotherapy treatment have shown a reduced response to therapy by approximately 20% compared to patients without obvious signs of stress, anxiety or depression (46% versus 65%).” Not only that: emotional distress was found to be linked, two years after treatment, to a higher risk of relapse (91% vs. 74%) e metastasis (95% versus 78%).

Detect discomfort immediately

Virtually all patients, and their families, experience an emotional shock when diagnosed with cancer: anger, desperation, fear take over initiallybut even subsequently about 50% of sufferers show symptoms of discomfort. Anxiety and depressive disorders significantly interfere with both adherence to therapy and quality of life, but there are effective methods to treat them, as long as they are recognized. While sick people should not be ashamed to ask for help, on the other it is essential that psychological suffering is detected immediately, as happens with vital parameters, as well as body temperature, heart and respiratory rate, blood pressure and pain. «Not only so that patients and families can live well, but also for the best effectiveness of treatments – concludes Ascierto -. Preclinical studies (on laboratory mice) show that emotional distress activates specific central nervous system mechanisms that can impair the function of several immune cells, “weakening” those responsible for neutralizing the disease and “strengthening” the immunosuppressive cells. Not only in melanoma: there are also indications on non-small cell lung cancer and colon cancer».

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December 29, 2023 (modified December 29, 2023 | 07:24)



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