Dermal Carotenoid Measurement is Inversely Related to Anxiety in Patients with Breast Cancer

Abstract

Breast cancer is the most prevalent malignancy among women worldwide. Increased oxidative stress and poor subjective health outcomes have been associated with increased risk of cancer recurrence and metastasis, but few studies until now have explored the relationship between oxidative stress and chronic stress/anxiety. This study aims to examine the association between anxiety and a potential dermal correlate of oxidative stress in patients with breast cancer. 102 breast cancer patients were enrolled in a cross-sectional study at Highland Hospital, a county hospital in Oakland, California. Each participant’s skin carotenoid score (SCS), a potential dermal correlate of oxidative stress, was recorded via Raman spectroscopy. Patient demographics, breast cancer stage, and subjective health measures (anxiety and self-rated health) were ascertained. Multivariate linear regression analysis was performed to quantify any associations between SCS and the above health correlates. Higher levels of skin carotenoids were associated with decreased severity of anxiety, lower BMI, increased servings of vegetables/fruits in daily diet, Hispanic race, lower educational status, and nonsmoking status. Severity of anxiety as graded by the GAD-7 was inversely associated with dermal carotenoid measurements via SCS. Conclusions. Increased levels of oxidative stress as quantified by SCS is associated with greater severity of anxiety. Because chronic stress has been associated with tumor progression, increased recurrence rates, and increased metastatic risk in breast cancer, non-invasive dermal carotenoid measurements could be used as a novel objective correlate of subjective health during cancer treatment.

Non-Inferiority Study on the Precise Implementation of Multidisciplinary Continuous Nursing Intervention in Patients with Breast Cancer Experiencing Negative Emotions

“…The ROC curve reflected that the disease progression events could be effectively distinguished with the SAS_A score, which was consistent with the conclusions drawn from previous studies. 9 In this study, area under the ROC curve (AUC) = 0.8306, Std.Error = 0.02353, 95% confidence interval (CI) = 0.7845 to 0.8767, a p-value of <0.0001, cut-off = 53.5, sensitivity = 66.67% (57.20% to 74.95%), and specificity = 86.51% (83.66% to 88.93%). As distinguished by the SAS_A cut-off value based on the KM analysis, it was found that there was a difference between the group with relatively high SAS_A scores and that with relatively low SAS_A scores, a p-value of <0.0001, the median of no events: SAS_Low: Un; SAS_High: 22 months; HR (high–low): 4.085 (2.582–6.462).…”

“… 8 Due to the complication of negative emotions, the mortality risk of patients with breast cancer is increased by 19%. 9 Group psychological intervention is conducive to the psychological adjustment of patients with breast cancer. 10 Conventional nursing models usually provide conventional psychological interventions for patients with breast cancer which have given initial results, but the overall effect is not ideal.…”

Carotenoids in Human Skin In Vivo: Antioxidant and Photo-Protectant Role against External and Internal Stressors

“…In a pilot study of 20 patients that were suffering from various cancers, it was shown that the concentration of carotenoids in the SC of patients that were measured before chemotherapy was significantly lower than that of healthy individuals ( p < 0.001) [ 219 ], probably due to the psychological burden and anxiety that cancer patients suffered from or the accumulating long-lasting effect of previous chemotherapy cycles [ 220 ]. Although the concentration of carotenoids in the SC does not correlate with the age of a healthy person [ 192 ], such a correlation has been found for the skin of patients suffering from cancer, which was decreasing with increasing patient age [ 221 ].…”

In vivo detection of changes in cutaneous carotenoids after chemotherapy using shifted excitation resonance Raman difference and fluorescence spectroscopy

“…[33][34][35][36][37][38] Furthermore, it can be stated that cancer subjects already show significantly lower SERRDS carotenoid intensities before chemotherapy treatment compared to healthy subjects. This can be due to the cancerous disease itself and associated emotional burden and stress, [39][40][41] due to co-medication or even to prior chemotherapeutical treatments at an earlier stage.…”