138. Cortisol and inflammatory processes in ovarian cancer patients following primary treatment: Relationships with depression, fatigue, and disability

Abstract

Elevations in the pro-inflammatory cytokine interleukin-6 (IL-6) and alterations in the antiinflammatory hormone cortisol have been reported in a variety of cancers. IL-6 has prognostic significance in ovarian cancer and cortisol has been associated with fatigue, disability, and vegetative depression in ovarian cancer patients prior to surgery. Ovarian cancer patients © 2012 Elsevier Inc. All rights reserved.Corresponding Author: Susan K. Lutgendorf, Ph.D. Department of Psychology University of Iowa E11 Seashore Hall Iowa City IA 52242 PH: 319-335-2432 FX: 319-335-0191 susan-lutgendorf@uiowa.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public AccessAuthor Manuscript Brain Behav Immun. Author manuscript; available in PMC 2014 March 01. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript undergoing primary treatment completed psychological self-report measures and collected salivary cortisol and plasma IL-6 prior to surgery, at six months, and at one year. Patients included in this study had completed chemotherapy and had no evidence of disease recurrence. At six months, patients showed significant reductions in nocturnal cortisol secretion, plasma IL-6, and a more normalized diurnal cortisol rhythm, changes that were maintained at one year. The reductions in IL-6 and nocturnal cortisol were associated with declines in self-reported fatigue, vegetative depression, and disability. These findings suggest that primary treatment for ovarian cancer reduces the inflammatory response. Moreover, patients who have not developed recurrent disease by one year appear to maintain more normalized levels of cortisol and IL-6. Improvement in fatigue and vegetative depression is associated with the normalization of IL-6 and cortisol, a pattern which may be relevant for improvements in overall quality of life for ovarian cancer patients.

Perceived efficacy of stress management skills, emotional distress, and diurnal cortisol in women with metastatic breast cancer.

“…Flattened or abnormal diurnal cortisol patterns also predicted increased risk of mortality in patients with metastatic renal cell carcinoma (Cohen et al, 2012) and lung cancer (Sephton et al, 2013). Thus, among patients with advanced cancers, abnormalities in HPA axis functioning associated with greater distress (Schrepf et al, 2012; Sephton et al, 2009) may hasten mortality.…”