Basal Cell Carcinoma

Abstract

Context Child emotional maltreatment can result in lasting immune dysregulation that may be heightened in the context of more recent life stress. Basal cell carcinoma (BCC) is the most common skin cancer, and the immune system plays a prominent role in tumor appearance and progression. Objective To address relationships among recent severe life events, childhood parental emotional maltreatment, depression, and messenger RNA (mRNA) coding for immune markers associated with BCC tumor progression/regression. Setting University medical center Design We collected information about early parent-child experiences, severe life events in the last year as assessed by the Life Events and Difficulties Schedule (LEDS), depression, and mRNA for immune markers associated with BCC tumor progression/regression from BCC tumor patients. Participants 91 BCC patients (ages 23–92) who had all had a previous BCC tumor. Main Outcome Measures The expression of four BCC tumor mRNA markers (CD25, CD3ε, ICAM-1, and CD68) that have been linked to BCC tumor progression/regression were assessed in BCC tumor biopsies. Results Both maternal and paternal emotional maltreatment interacted with the occurrence of severe life events to predict the local immune response to the tumor (adjusted p=0.009, p=0.03, respectively). Among BCC patients who had experienced a severe life event within the past year, those who were emotionally maltreated by their mothers (p=0.007) or fathers (p=0.02) as children had a poorer immune response to the BCC tumor. Emotional maltreatment was unrelated to BCC immune responses among those who did not experience a severe life event. Depressive symptoms were not associated with the local tumor immune response. Conclusions Troubled early parent-child relationships, in combination with a severe life event in the past year, predicted immune responses to a BCC tumor. The immunoreactivity observed in BCCs and the surrounding stroma reflects an anti-tumor-specific immune response that can be altered by stress.

Biobehavioral approaches to cancer progression and survival: Mechanisms and interventions.

“…(Messenger RNA enables the DNA’s genetic information to be translated into the creation of proteins.) Among BCC patients with high levels of life stress, those who suffered from maltreatment as children showed a poorer immune response than those without a history of adversity, but in patients without life stress there was no relationship between immune response and early life adversity (Fagundes et al, 2012). Such findings highlight associations between psychosocial risk factors and the cellular immune response in the tumor microenvironment and also highlight the potential role of early life stress in influencing trajectories of vulnerability and disease.…”

Routine Versus Catastrophic Influences on the Developing Child

“…For example, the immune response of basal cell carcinoma tumors varies as a function of the patient’s childhood history of emotional maltreatment and the presence of a recent stressful life event (58). A greater number of childhood adversities among breast cancer survivors also influences cellular immune function, responsiveness to treatment, and overall health (59).…”

Childhood Adversity and Inflammation in Breast Cancer Survivors

“…Evidence from human studies suggests that childhood stress is associated with immune dysregulation in patients with cancer and cancer survivors, including poorer immune response to basal cell carcinoma tumors in those who had also experienced a traumatic stressor within the previous year (23) and higher expression of two latent herpes virus antibody titers in breast cancer survivors (24). To our knowledge, only one previous study has examined the association between childhood adversity and inflammation in women with breast cancer.…”