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

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Depression and cancer: mechanisms and disease progression

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

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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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Self-citation

Authors: Spiegel, D., & Giese-Davis, J.
Affiliations: Stanford Medicine (US)
ORCID: Spiegel, David
Venue: Biological Psychiatry
Publisher: Elsevier BV
Published: 2003-08
Volume: 54
Issue: 3
Pages: 269-282
ISSN: 0006-3223 (ISSN-L)
DOI: 10.1016/s0006-3223(03)00566-3
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
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
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: Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › 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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