Circulating catecholamines are associated with biobehavioral factors and anxiety symptoms in head and neck cancer patients

Abstract

Studies have shown that stress-related catecholamines may affect cancer progression. However, little is known about catecholamine secretion profiles in head and neck cancer patients. The present study investigated plasma norepinephrine and epinephrine levels in head and neck squamous cell carcinoma (HNSCC) patients and patients with oral leukoplakia, as well as their association with clinicopathological and biobehavioral variables and anxiety symptoms. A total of 93 patients with HNSCC and 32 patients with oral leukoplakia were included. Plasma norepinephrine and epinephrine levels were measured by high performance liquid chromatography with electrochemical detection (HPLC-ED), and psychological anxiety levels were measured by the Beck Anxiety Inventory (BAI). Plasma norepinephrine and epinephrine concentrations were significantly higher in patients with oral and oropharyngeal squamous cell carcinoma (SCC) compared to non-cancer patients. Oral SCC patients displayed plasma norepinephrine levels about six times higher than oropharyngeal SCC patients, and nine times higher than oral leukoplakia patients (p < .001). Plasma epinephrine levels in oral SCC patients were higher compared to the oropharyngeal SCC (p = .0097) and leukoplakia (p < .0001) patients. Oropharyngeal SCC patients had higher plasma norepinephrine (p = .0382) and epinephrine levels (p = .045) than patients with oral leukoplakia. Multiple regression analyses showed that a history of high alcohol consumption was predictive for reduced plasma norepinephrine levels in the oral SCC group (p < .001). Anxiety symptom of “hand tremor” measured by the BAI was an independent predictor for higher plasma norepinephrine levels in HNSCC patients (β = 157.5, p = .0377), while the “heart pounding/racing” symptom was independently associated with higher plasma epinephrine levels in the oropharyngeal SCC group (β = 15.8, p = .0441). In oral leukoplakia patients, sleep deprivation and worse sleep quality were independent predictors for higher plasma norepinephrine levels, while severe tobacco consumption and higher anxiety levels were factors for higher plasma epinephrine levels. These findings suggest that head and neck cancer patients display sympathetic nervous system hyperactivity, and that changes in circulating catecholamines may be associated with alcohol consumption, as well as withdrawal-related anxiety symptoms.

Might anxiety disorders promote head and neck cancer development?

“…In the current study, no differences were observed in BAI scores in the case and control group. Similar BAI results were found before ( Bastos et al, 2018 ). Stressful events that occur in the presence of social support have less emotional consequences than if they happen in the absence of social support.…”

“…Studies report that the patient with HNSCC most often suffers from the physical, mental, and psychosomatic impacts inherent to the diagnosis of the neoplasia and its treatment; above all, it is possible to highlight Anxiety and depression as a result of such impacts ( Chen et al, 2009 ). On the other hand, recently, it was demonstrated that HNSCC patients display sympathetic nervous system hyperactivity and that changes in circulating catecholamines may be associated with alcohol consumption( Bastos et al, 2018 ). Moreover, chronic stress was related to oral carcinoma growth rate and progression ( Xie et al, 2015 ).…”

Assessment of Epinephrine and Norepinephrine in Gastric Carcinoma

“…In other primary tumors, the activity of the sympathetic nervous system has been evaluated in both preclinical and clinical studies. The plasma norepinephrine and epinephrine concentrations are significantly higher in patients with oral and oropharyngeal squamous cell carcinoma (SCC) than in non-cancer patients [ 33 ]. In epithelial ovarian cancer, norepinephrine reduces cisplatin’s efficacy and can affect DNA integrity [ 34 ].…”

Forensic Autosomal Short Tandem Repeats and Their Potential Association With Phenotype

“…Previous studies (McEwen, 2002;Antoni et al, 2006;Bastos et al, 2018) have shown that increased levels of epinephrine and norepinephrine are expressed in individuals experiencing acute or chronic stress. Wei et al (1997) found that individuals carrying the TH01-9 allele showed the highest levels of serum norepinephrine amongst a population of unrelated healthy adults, whereas carriers of the TH01-7 allele showed the lowest.…”