Cited by 874Cancer, Stress, Anesthesia, and Immune ResponseCancer survivorship and careTryptophan and brain disorders

Depression and cancer: mechanisms and disease progression

Spiegel, David, Giese-Davis, Janine·2003·Biological Psychiatry

Abstract

Depression and cancer commonly co-occur. The prevalence of depression among cancer patients increases with disease severity and symptoms such as pain and fatigue. The literature on depression as a predictor of cancer incidence is mixed, although chronic and severe depression may be associated with elevated cancer risk. There is divided but stronger evidence that depression predicts cancer progression and mortality, although disentangling the deleterious effects of disease progression on mood complicates this research, as does the fact that some symptoms of cancer and its treatment mimic depression. There is evidence that providing psychosocial support reduces depression, anxiety, and pain, and may increase survival time with cancer, although studies in this latter area are also divided. Psychophysiological mechanisms linking depression and cancer progression include dysregulation of the hypothalamic-pituitary-adrenal axis, especially diurnal variation in cortisol and melatonin. Depression also affects components of immune function that may affect cancer surveillance. Thus, there is evidence of a bidirectional relationship between cancer and depression, offering new opportunities for therapeutic intervention.

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Crossref · 10.1016/s0006-3223(03)00566-3

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149 of 149 references verified0 citation errors · 0 not checkable

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Authors
Spiegel, D., & Giese-Davis, J.
Affiliations
Stanford Medicine (US)
Venue
Biological Psychiatry
Publisher
Elsevier BV
Published
2003-08
Volume
54
Issue
3
Pages
269-282
ISSN
0006-3223 (ISSN-L)
OpenAlex
W2032018235
Cited by
874
References
147
Citations by year
2026: 27 · 2025: 36 · 2024: 36 · 2023: 35 · 2022: 42 · 2021: 42 · 2020: 55 · 2019: 43 · 2018: 44 · 2017: 28 · 2016: 37 · 2015: 42 · 2014: 36 · 2013: 40 · 2012: 58
FWCI
3.61
Type
journal article
Language
en
Open access
closed
Locations
  • Biological Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Cancer Institute
  • National Institutes of Health (5R01 MH047226)
  • National Institute of Mental Health (5P01AG018784)
  • National Institute on Aging
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Cancer, Stress, Anesthesia, and Immune Response
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
Keywords
depression, cancer, tumor progression, cancer mortality, cancer incidence, psychosocial support, hypothalamic-pituitary-adrenal axis, cortisol, melatonin, immune function, cancer surveillance, pain, fatigue, bidirectional relationship
MeSH terms
Adrenal Glands, Depressive Disorder, Humans, Hypothalamo-Hypophyseal System, Neoplasms, Risk Factors, Treatment Refusal, Disease Progression

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