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      Depression and cancer: mechanisms and disease progression

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      Biological Psychiatry
      Elsevier BV

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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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          Author and article information

          Journal
          Biological Psychiatry
          Biological Psychiatry
          Elsevier BV
          00063223
          August 2003
          August 2003
          : 54
          : 3
          : 269-282
          Article
          10.1016/S0006-3223(03)00566-3
          12893103
          504c9b5d-7505-4d81-9535-2d12b86f6924
          © 2003

          https://www.elsevier.com/tdm/userlicense/1.0/

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