Psychosocial factors, biological mediators, and cancer prognosis: a new look at an old story.
OBJECTIVE
The present article briefly reviews the prognostic role of psychosocial factors in cancer and concentrates on biological markers that may mediate such relationships. We focus on specific markers that show promising mediating roles.


RESULTS
The article reviews the prognostic role of psychosocial factors as shown in longitudinal studies and in previous reviews. We present the general stress response and its relevance to cancer progression. The main focus of the article is on the prognostic roles of specific biomarkers that had to meet three criteria for being accepted as biomarkers - being related to a psychosocial factor at the level of the brain, the circulation, and the tissue/cellular level. We review studies supporting the mediating roles of neurohormones and neurotransmitters (e.g., cortisol, norepinephrine), the vagal nerve and inflammation, interleukin-1, DNA damage, and the hormone oxytocin.


CONCLUSIONS
These biomarkers may mediate the relationships between certain psychosocial factors (e.g., hopelessness, social support) and cancer progression. Future studies should test the effects of altering such biomarkers on the prognosis of patients scoring high/low on their associated psychosocial factors. Clinical implications that need to be tested are provided.
Gidron
Yori
Y
Brunel University, Uxbridge, Middlesex, UK bInstitute of Jules Bordet, The Free University of Brussels, Brussels, Belgium. Yori.Gidron@brunel.ac.uk
Ronson
Alain
A
D000818:Animals; D001007:Anxiety / Q000378:metabolism*; D003687:Dehydroepiandrosterone / Q000378:metabolism*; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism*; D009369:Neoplasms / Q000378:metabolism / Q000523:psychology*; D010913:Pituitary-Adrenal System / Q000378:metabolism*; D013315:Stress, Psychological / Q000378:metabolism*
D003687:Dehydroepiandrosterone