Cited by 377Circadian rhythm and melatoninCancer, Stress, Anesthesia, and Immune ResponseStress Responses and Cortisol

Circadian disruption in cancer: A neuroendocrine-immune pathway from stress to disease?

Sephton, Sandra, Spiegel, David·2003·Brain Behavior and Immunity

Abstract

Psychosocial factors may modulate the course of cancer, but few data have been gathered on the biological mechanisms by which these effects may be mediated. We briefly review evidence of psychosocial effects on cancer progression and discuss one potential pathway that may underlie these effects: the disruption of neuroendocrine and immune circadian rhythms. Circadian system alterations occur in tumor tissue, tumor-bearing animals, and cancer patients with greater disruption seen in more advanced cases. Rhythm alterations include diminished amplitude, phase shifts, period changes, and erratic peaks and troughs in endocrine, metabolic, immunological, and rest- activity cycles. Psychosocial factors can engender dysregulation of circadian function. Cancer-related circadian dysregulation may also be driven by genetic factors, environmental and behavioral influences, and effects of the tumor on host clock regulation. There are several mechanisms by which circadian disruption might hasten tumor growth: via direct effects of altered hormone levels on tumor cells, effects on tumor versus host metabolism, neuroimmune effects resulting in cancer-relevant immunosuppression, or reduced efficacy and tolerability of cancer treatments for which the timing of administration is based upon the assumption of normal circadian rhythms. Emerging data in the human and animal literature suggest that circadian regulation may be an important prerequisite for the maintenance of host defenses against cancer. Thus, stress-related circadian disruption may have negative implications for cancer prognosis. Psychosocial effects on cancer progression may be measured, and possibly mediated, by disruption of circadian function.

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Crossref · 10.1016/s0889-1591(03)00078-3

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Authors
Sephton, S., & Spiegel, D.
Affiliations
  • University of Louisville (US)
  • Stanford Medicine (US)
Corresponding author
Sephton, Sandra
Venue
Brain Behavior and Immunity
Publisher
Elsevier BV
Published
2003-10
Volume
17
Issue
5
Pages
321-328
ISSN
0889-1591 (ISSN-L)
OpenAlex
W1985105677
Cited by
377
References
37
Citations by year
2026: 11 · 2025: 12 · 2024: 11 · 2023: 11 · 2022: 16 · 2021: 18 · 2020: 14 · 2019: 26 · 2018: 18 · 2017: 13 · 2016: 18 · 2015: 11 · 2014: 16 · 2013: 21 · 2012: 21
FWCI
1.53
Type
journal article
Language
en
Open access
closed
Locations
  • Brain Behavior and Immunity (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
  • Health Sciences › Medicine › Psychiatry and Mental health › Cancer, Stress, Anesthesia, and Immune Response
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Keywords
circadian rhythm disruption, tumor progression, psychosocial factors, circadian rhythm, stress, tumor immunosuppression, host defense against cancer, circadian clock regulation, cancer prognosis
MeSH terms
Animals, Circadian Rhythm, Humans, Neoplasms, Neurosecretory Systems, Prognosis, Psychology, Neuroimmunomodulation, Disease Progression, Chronobiology Disorders

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