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Elevated depression, shortened telomeres increased bladder cancer mortality
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The combination of shortened telomeres and elevated depression caused a threefold increase in bladder cancer mortality, according to study results.
Evidence suggests that depression is associated with increased mortality in cancer. Several trials have been proposed to explain the link between depression and cancer, but no study has examined depression and telomere length in cancer outcomes, according background information from the study.
In a prospective study, researchers collected clinical and mental health information from 464 patients with bladder cancer and examined patients’ depression levels using the Center for Epidemiology Studies Depression Scale (CES-D).
During median follow-up (21.6 months), 88 deaths occurred.
According to results from the study, depression symptoms alone affected mortality.
Patients with CES-D scores ≥16 had a 1.89-fold increase for all-cause mortality compared with patients with scores ≤16 (95% CI, 1.12-3.2).
Patients with CES-D scores ≥16 showed a shorter median survival time (58 months) compared with patients with scores ≤16 (>200 months; P=.004).
Meng Chen, PhD, epidemiologist in the department of epidemiology at The University of Texas MD Anderson Cancer Center, and colleagues measured telomere length from patient blood samples.
Univariate analysis from the study showed that long telomeres were associated with improved survival (HR=0.55; 95% CI, 0.34-0.89). This result was not significant in a multivariate analysis, the study found.
Researchers found that patients with depression symptoms (CES-D scores ≥16) and short telomeres had more than a threefold increased risk for mortality (HR=3.19; 95% CI, 1.44-7.04) and significantly shorter DFS (31.3 months vs. 199.8 months; P<.001) compared with patients without depression symptoms (CES-D scores <16) and longer telomeres.
“These results suggest the potential important role of psychological factors to improve survival in cancer patients,” Chen said in a press release.
Quitting smoking, weight loss and increased physical activity can slow telomere shortening, potentially improving survival, according to the study.
Chen said the study findings should be further studied.
“In terms of building a prediction model for bladder cancer mortality, current models only focus on clinical variables, such as treatment and tumor stage and grade,” Chen concluded in a press release. “Our study suggests that psychological factors and perhaps lifestyle could be included in this prediction model.”
For more information:
Chen M. Abstract #138675_1. Presented at: AACR International Conference on Frontiers in Cancer Prevention Research. Oct. 16-19, 2012; Anaheim, Calif.
Disclosure: Meng and colleagues report no relevant financial disclosures.
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Harry S. Jacob, MD, FRCPath(Hon)
Previous studies in baboons in the journal Science demonstrated shortened survival in cancer-induced animals undergoing psychological stress (two males caged with one female). I have encouraged anti-depressants in all patients undergoing leukemia treatments and am enthused by these studies.
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