Depressed head and neck cancer patients three-and-one-half times less likely to survive, have higher recurrence risk

It is already known that depression can depress the immune system.

http://www.eurekalert.org/pub_releases/2015-12/uotm-dha120315.php

Public Release: 3-Dec-2015
Depressed head and neck cancer patients three-and-one-half times less likely to survive, have higher recurrence risk
MD Anderson study definitively links depression to outcome
University of Texas M. D. Anderson Cancer Center

Depression is a significant predictor of five-year survival and recurrence in head and neck cancer patients, according to a new study from The University of Texas MD Anderson Cancer Center. These findings, published in Pyschosomatic Medicine, represent one of the largest reported impacts of depression on cancer survival.

Although depression can have obvious detrimental effects on an individual's quality of life, the impact on that of cancer patients is becoming more apparent, explained Eileen Shinn, Ph.D., assistant professor, Behavioral Science, MD Anderson, and lead author of the study. There is increasing evidence for modest associations between elevated symptoms of depression and increased mortality risk in lung, breast, ovarian and kidney cancer.

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"The results of this study were quite intriguing, showing depression was a significant factor predicting survival at five years, even after controlling for commonly accepted prognostic factors," said senior author Adam Garden, M.D., professor, Radiation Oncology.

In fact, depression was the only factor shown to have a significant impact on survival.

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Neither alcohol nor tobacco use, also surveyed in this group, had a significant impact on survival. HPV infection status, when available, did not appear correlated either.

Despite a high cure rate for OSCC, normally between 60-80 percent, there is an unusually high rate of recurrence in these patients of about 30 percent. As depression was connected to survival, the researchers also investigated a potential link to disease recurrence.

"When we controlled for all variables, depression was linked with a nearly four times higher risk of recurrence," said Shinn. "Also, those who had never smoked, compared to current smokers, had a 73 percent lower chance of recurrence." Those were the only two factors associated with cancer recurrence.

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Possible mechanisms include poor lifestyle behaviors associated with depression, or a different biological response to chronic inflammation that affects cancer biology. These questions, however, will need to be answered in future research.