title: Endocrine levels at the start of treatment are associated with subsequent psychological adjustment in cancer patients with metastatic disease.
abstract: OBJECTIVE
  This study examined the association between hormonal profiles at the start of cancer treatment and subsequent psychological symptomatology.
  
  
  METHODS
  Twenty-seven patients with metastatic renal cell carcinoma and 18 patients with metastatic melanoma completed three assessments during the course of treatment: at the start of treatment (baseline), at the end of treatment (3 weeks after baseline), and at a follow-up appointment 1 month later. Cortisol, norepinephrine, and epinephrine levels were measured at baseline using 15-hour urine samples. At each assessment, patients completed the Impact of Event Scale (IES) and the Brief Symptom Inventory (BSI).
  
  
  RESULTS
  Patients reported moderate levels of distress throughout treatment as measured by the IES and BSI. Norepinephrine levels at the start of treatment were positively associated with IES total scores at the end of treatment and at follow-up, and cortisol levels were positively associated with IES total scores at follow-up after adjusting for baseline IES and overall distress scores. Norepinephrine levels were also positively associated with depression scores at follow-up, and cortisol levels were positively associated with depression scores at the end of treatment and at follow-up after adjusting for baseline depression and overall distress scores.
  
  
  CONCLUSIONS
  Hormonal profiles at the start of cancer treatment are associated with subsequent psychological adjustment.
authors.affiliation: Department of Behavioral Science, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA. lcohen@mdanderson.org
authors.forename: L
authors.initials: L
authors.lastname: Cohen
authors.forename: C
authors.initials: C
authors.lastname: de Moor
authors.forename: D
authors.initials: D
authors.lastname: Devine
authors.forename: A
authors.initials: A
authors.lastname: Baum
authors.forename: R J
authors.initials: RJ
authors.lastname: Amato
mesh_terms: D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000523:psychology* / Q000556:secondary / Q000628:therapy*; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology*; D008297:Male; D008545:Melanoma / Q000523:psychology* / Q000556:secondary / Q000628:therapy*; D008875:Middle Aged; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000523:psychology / Q000628:therapy; D010913:Pituitary-Adrenal System / Q000502:physiology*; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D006854:Hydrocortisone