A neuron enriching protein plays a key role in how well people respond to chemotherapy, researchers report.
A study found that cancer patients with depression have lowered amounts of brain-derived neurotophic factor (BDNF) in their blood. Low levels make people less responsive to cancer drugs and less tolerant of their side-effects.
Lead author Yufeng Wu, head of oncology, department of internal medicine, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China, said:
“It’s crucial doctors pay more attention to the mood and emotional state of patients. Depression can reduce the effects of chemotherapy and BDNF plays an important role in this process."
Brain-derived Neurotophic Factor
Lowered mood is common among cancer patients, especially the terminally ill. Depressive disorder is estimated to occur in 10%–25% of patients with cancer, which is greater than twice the rate in the general population.
BDNF is essential for healthy brain function and low levels have already been linked with mental illness. This study aimed to discover how depression influenced outcomes for people with advanced lung cancer.
Researchers recruited 186 newly diagnosed lung cancer patients receiving chemotherapy. To assess their state of mind, they were asked to rate their depression levels the day before treatment began.
Quality of life details, overall survival and other data were also collected. This allowed researchers to compare this information with the patients' mood scores.
Those whose cancer had spread to other organs, results showed, were the most depressed and this severely decreased their tolerance to chemotherapy. It was associated with vomiting, a reduction in white blood cells, and prolonged hospital stays.
The impact of severe depression was even greater. It reduced the length of time that patients lived with the disease without it getting worse.
Researchers found that BDNF clearly boosted the number of tumor cells killed by chemotherapy.
Patients with severe depression had lower levels of the protein in the blood so their bodies were not as effective at fighting cancer. This reduced their chance of surviving the disease.
“Our aim now is to prescribe drugs such as fluoxetine to depressed patients and study their sensitivity to chemotherapy,” added Wu.
Commenting on the results of the research, Ravindran Kanesvaran, consultant medical oncologist and assistant professor, Duke-NUS Medical School, Singapore, said:
“The link between depression and poor outcomes among these patients is significant and can be associated with the downregulation of brain derived neurotrophic factor.
This finding can perhaps lead to new ways to treat depression in these patients which in turn may prolong their lives. Further research is needed to establish the effects of different anti-depressant drugs on BDNF levels."
The work was supported by grants from Ph.D. Research Foundation of Henan Cancer Hospital, the National Science Foundation of China, and the Key Science and Technology Research Foundation of Henan Province.
The study results are presented at the European Society for Medical Oncology Asia 2016 Congress in Singapore.
Yufeng Wu Depression induces poor prognosis via the downregulation of brain derived neurotrophic factor in advanced small cell lung cancer Abstract 497O_PR Session: Supportive and palliative care ESMO Asia 2016 Sunday 18th December 10:00
Yufeng Wu, Ruirui Si, Sen Yang, Suhua Xia, Zelai He Lili Wang, Zhen He, Qiming Wang, Hong Tang Depression induces poor prognosis associates with the down-regulation brain derived neurotrophic factor of serum in advanced small cell lung cancer Oncotarget DOI: 10.18632/oncotarget.13291
Image: Bone cancer cell. D. Burnette, J. Lippincott-Schwartz/NICHD