Schizophrenia and cancer: Is angiogenesis a missed link?

Lopes, Rui; Soares, Raquel; Figueiredo-Braga, Margarida; Coelho, Rui

doi:10.1016/j.lfs.2013.12.023

Cited by 10 publications

(9 citation statements)

References 71 publications

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“…According to the literature, authors from many countries have described the interesting relation between schizophrenia and cancer . However, consistent results are lacking because they focus on different cancer sites, patients’ lifestyles and physical comorbidities, survey periods and age‐specific surveys, and different ethnicities.…”

Section: Overview Of Methodology For the Study Of Cancer In Schizophrmentioning

confidence: 99%

“…The outcomes might be inconsistent depending on the variety of participants, different methodologies, or confounding factors that may not be well controlled, such as smoking. The results of related studies are summarized in Table …”

Section: Overview Of Methodology For the Study Of Cancer In Schizophrmentioning

confidence: 99%

“…The incidence of cancer in people with schizophrenia has been reported to be increased, reduced, or similar compared with the general population . Several studies have reported lower incidence rates, fueling speculation regarding biological and other mechanisms for this protective effect.…”

Section: Incidence Of Cancer In People With Schizophreniamentioning

confidence: 99%

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Cancer in patients with schizophrenia: What is the next step?

Chou

Tsai

et al. 2016

Psychiatry Clin Neurosci

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People with schizophrenia, who constitute approximately 0.3-1% of the general population, have a nearly 20% shorter life expectancy than the general population. The incidence of varied types of cancers in patients with schizophrenia is controversial. The majority of previous research has demonstrated that patients who have schizophrenia and cancer have early mortality compared to the general population with cancer. The causes of early mortality in patients with schizophrenia and cancer might be attributed to a lower cancer screening rate and lack of effective treatment, including: (i) patient factors, such as poor lifestyle, passive attitude toward treatment, or comorbidity; (ii) physician factors, such as physician bias, which may decrease the delivery of care for individuals with mental disorders; and (iii) hospital administration factors, such as stigma and discrimination. Additional studies on patients with schizophrenia and cancer are warranted and should include the following: a comprehensive review of previous studies; a focus on differentiating the specific types of cancer; and methods for improvement. To decrease the early mortality of patients with schizophrenia, the following measures are proposed: (i) enhance early detection and early treatment, such as increasing the cancer screening rate for patients with schizophrenia; (ii) provide effective, timely treatment and rehabilitation; (iii) improve patients' psychiatric symptoms and cognitive impairment; (iv) promote healthy behavior in the general population and emphasize healthy lifestyles in vulnerable populations; and (v) remove the stigma of schizophrenia. To reduce disparities in physical health, public health strategies and welfare policies must continue to focus on this group of patients.

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Section: Overview Of Methodology For the Study Of Cancer In Schizophrmentioning

confidence: 99%

Section: Overview Of Methodology For the Study Of Cancer In Schizophrmentioning

confidence: 99%

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Cancer in patients with schizophrenia: What is the next step?

Chou

Tsai

et al. 2016

Psychiatry Clin Neurosci

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“…With respect to this, changes in endocrine hormones caused by antipsychotic medications, familial or genetic factors (eg, tumor suppressor gene p53, enhanced natural killer cell activity, angiogenesis, or DNA repair mechanisms), reduced parity and hyperprolactinaemia may be factors contributing to determine such contradictory results. [34][35][36] Regarding bipolar disorders, elderly people are reported to have a delay in receiving specific cancer treatment, although no studies have investigated treatment outcomes. 37 Also, a study carried out in Israel showed an enhanced cancer risk for bipolar disorder both in men (Standardized Incidence Ratio, SIR 1.59) and women, (SIR 1.75) 38 As stated by Howard et al, 39 when interpreting these results, it is useful to consider the effect of missing cancer diagnoses, short-ended life expectancy, the characteristics of health-service contexts, behavioral risk factors, and the possibility that genetic or drug effects can influence the results of the studies.…”

Section: Incidence Of Cancer and Cancer Mortality In People With Smimentioning

confidence: 99%

Cancer and severe mental illness: Bi‐directional problems and potential solutions

Grassi

Riba

2020

Psycho-Oncology

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Objective: Given the reported increased rates of physical morbidity and higher mortality rates among people with severe mental illness (SMI) (schizophrenia and severe mood disorders), with a life expectancy shorter of 15-20 years with respect to the general population, the aim of this paper was to call attention to the problem of cancer in SMI. Methods: We conducted a narrative review of the most significant papers published in the areas of cancer screening, incidence, mortality and palliative care in SMI. Results: Data from the literature confirm disparities in screening (eg, mammography; pap-smear test; colorectal cancer screening) and prevention (eg, clinical breast examination; smoking cessation). The incidence of cancer was found to be variable with a portion of the studies reporting a higher prevalence while others a similar or a lower prevalence of cancer compared to the general population. A lower percentage of patients with SMI received proper cancer treatment resulting in survival after cancer diagnosis significantly worse than people without SMI. Likewise, end-of-life care has been shown to be lacking with poorer levels of physical, psychological and spiritual care. Conclusions: The problems of stigma and discrimination, poorer dignity, poorer health behavior, lack of integration in health-care services for people with SMI needs to be addressed and solved in cancer care. Psycho-oncology has a very specific and mandatory role in integrating the recommendation of the World Health Organization to improve the links between oncology and mental health settings for more specific psycho-oncology programs addressed for this vulnerable segment of the population.

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“…It has been reported that the overall cancer incidence rate among schizophrenia patients is significantly lower than that of the general population [60][61][62], and the influence antipsychotic drugs may have on cancer incidence has also been reported, although penfluridol was not included in that systematic review [63]. Similarly, angiogenesis has been reported to be the missing link in this reverse correlation; however, no supporting data have been presented to date [64]. Given the present findings, it would be interesting to correlate penfluridol use with cancer incidence and outcome of anti-cancer treatment of the prescribed patients.…”

Section: Discussionmentioning

confidence: 98%

Low Dose of Penfluridol Inhibits VEGF-Induced Angiogenesis

Srivastava

Zahra

Gupta

et al. 2020

IJMS

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Metastasis is considered a major burden in cancer, being responsible for more than 90% of cancer-related deaths. Tumor angiogenesis is one of the main processes that lead to tumor metastasis. Penfluridol is a classic and commonly used antipsychotic drug, which has a great ability to cross the blood–brain barrier. Recent studies have revealed that penfluridol has significant anti-cancer activity in diverse tumors, such as metastatic breast cancer and glioblastoma. Here, we aim to identify the effect of low doses of penfluridol on tumor microenvironment and compare it with its effect on tumor cells. Although low concentration of penfluridol was not toxic for endothelial cells, it blocked angiogenesis in vitro and in vivo. In vitro, penfluridol inhibited VEGF-induced primary endothelial cell migration and tube formation, and in vivo, it blocked VEGF- and FGF-induced angiogenesis in the matrigel plug assay. VEGF-induced VEGFR2 phosphorylation and the downstream p38 and ERK signaling pathways were not affected in endothelial cells, although VEGF-induced Src and Akt activation were abrogated by penfluridol treatment. When cancer cells were treated with the same low concentration of penfluridol, basal Src activation levels were mildly impaired, thus impacting their cell migration and wound healing efficiency. The potential of cancer-induced paracrine effect on endothelial cells was explored, although that did not seem to be a player for angiogenesis. Overall, our data demonstrates that low penfluridol levels, similar to the ones clinically used for anti-psychotic conditions, suppress angiogenic efficiency in the tumor microenvironment.

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Schizophrenia and cancer: Is angiogenesis a missed link?

Cited by 10 publications

References 71 publications

Cancer in patients with schizophrenia: What is the next step?

Cancer in patients with schizophrenia: What is the next step?

Cancer and severe mental illness: Bi‐directional problems and potential solutions

Low Dose of Penfluridol Inhibits VEGF-Induced Angiogenesis

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