title: Vascular endothelial growth factor and social support in patients with ovarian carcinoma.
abstract: BACKGROUND
  The modulation of immunologic activities relevant to cancer by behavioral factors, such as stress, depression, and social support, is well documented. However, associations of behavioral factors with cytokines involved in tumor angiogenesis have not been studied. Vascular endothelial growth factor (VEGF) is a key cytokine that is capable of stimulating tumor angiogenesis, and it has been associated with poorer survival in patients with ovarian carcinoma. VEGF is modulated by a variety of behaviorally sensitive factors, including sympathetic activation. This study examined relationships of social support and depressive symptoms with VEGF levels in preoperative patients with ovarian carcinoma.
  
  
  METHODS
  Twenty-four women with ovarian carcinoma and 5 women with benign pelvic masses were recruited at the presurgical clinic visit, received psychosocial surveys, including the Functional Assessment of Cancer Therapy (Quality of Life) survey and the Profile of Mood States, and a blood draw. Serum VEGF levels were assessed by enzyme-linked immunosorbent assay. Analyses controlled for disease stage.
  
  
  RESULTS
  Women with ovarian carcinoma who reported higher levels of social well being had lower levels of VEGF (P = 0.005). Greater support from friends and neighbors (P = 0.005) and less distance from friends (P = 0.04) were facets of social well being that were associated with lower VEGF levels. Individuals who reported greater helplessness (P = 0.03) or worthlessness (P = 0.08) had higher VEGF levels, but depression as a whole (P > 0.50) was not related to VEGF levels.
  
  
  CONCLUSIONS
  Higher levels of social well being were correlated with lower VEGF levels in presurgical patients with ovarian carcinoma. These findings suggest a possible mechanism by which poor social support may be associated with disease progression. Further study of these relations may demonstrate novel pathways relating biobehavioral factors to tumor growth and disease progression.
authors.affiliation: Department of Psychology, University of Iowa, Iowa City, Iowa 52242, USA. susan-lutgendorf@uiowa.edu
authors.forename: Susan K
authors.initials: SK
authors.lastname: Lutgendorf
authors.forename: Erica L
authors.initials: EL
authors.lastname: Johnsen
authors.forename: Brian
authors.initials: B
authors.lastname: Cooper
authors.forename: Barrie
authors.initials: B
authors.lastname: Anderson
authors.forename: Joel I
authors.initials: JI
authors.lastname: Sorosky
authors.forename: Richard E
authors.initials: RE
authors.lastname: Buller
authors.forename: Anil K
authors.initials: AK
authors.lastname: Sood
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000378:metabolism* / Q000523:psychology*; D003863:Depression / Q000378:metabolism; D016228:Endothelial Growth Factors / Q000378:metabolism*; D005260:Female; D006801:Humans; D008222:Lymphokines / Q000378:metabolism*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000378:metabolism* / Q000523:psychology; D011788:Quality of Life; D012944:Social Support; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors
chemical_list: D016228:Endothelial Growth Factors; D008222:Lymphokines; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors