title: Cortisol and inflammatory processes in ovarian cancer patients following primary treatment: relationships with depression, fatigue, and disability.
abstract: Elevations in the pro-inflammatory cytokine interleukin-6 (IL-6) and alterations in the anti-inflammatory hormone cortisol have been reported in a variety of cancers. IL-6 has prognostic significance in ovarian cancer and cortisol has been associated with fatigue, disability, and vegetative depression in ovarian cancer patients prior to surgery. Ovarian cancer patients undergoing primary treatment completed psychological self-report measures and collected salivary cortisol and plasma IL-6 prior to surgery, at 6 months, and at 1 year. Patients included in this study had completed chemotherapy and had no evidence of disease recurrence. At 6 months, patients showed significant reductions in nocturnal cortisol secretion, plasma IL-6, and a more normalized diurnal cortisol rhythm, changes that were maintained at 1 year. The reductions in IL-6 and nocturnal cortisol were associated with declines in self-reported fatigue, vegetative depression, and disability. These findings suggest that primary treatment for ovarian cancer reduces the inflammatory response. Moreover, patients who have not developed recurrent disease by 1 year appear to maintain more normalized levels of cortisol and IL-6. Improvement in fatigue and vegetative depression is associated with the normalization of IL-6 and cortisol, a pattern which may be relevant for improvements in overall quality of life for ovarian cancer patients.
authors.affiliation: Department of Psychology, University of Iowa, Iowa City, IA 52242, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Schrepf
authors.forename: Lauren
authors.initials: L
authors.lastname: Clevenger
authors.forename: Desire
authors.initials: D
authors.lastname: Christensen
authors.forename: Koen
authors.initials: K
authors.lastname: DeGeest
authors.forename: David
authors.initials: D
authors.lastname: Bender
authors.forename: Amina
authors.initials: A
authors.lastname: Ahmed
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Goodheart
authors.forename: Laila
authors.initials: L
authors.lastname: Dahmoush
authors.forename: Frank
authors.initials: F
authors.lastname: Penedo
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Lucci
authors.forename: Parvin
authors.initials: P
authors.lastname: Ganjei-Azar
authors.forename: Luis
authors.initials: L
authors.lastname: Mendez
authors.forename: Kristian
authors.initials: K
authors.lastname: Markon
authors.forename: David M
authors.initials: DM
authors.lastname: Lubaroff
authors.forename: Premal H
authors.initials: PH
authors.lastname: Thaker
authors.forename: George M
authors.initials: GM
authors.lastname: Slavich
authors.forename: Anil K
authors.initials: AK
authors.lastname: Sood
authors.forename: Susan K
authors.initials: SK
authors.lastname: Lutgendorf
mesh_terms: D000368:Aged; D002940:Circadian Rhythm; D003863:Depression / Q000523:psychology*; D006233:Persons with Disabilities; D005221:Fatigue / Q000523:psychology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D007249:Inflammation / Q000378:metabolism / Q000523:psychology; D015850:Interleukin-6 / Q000032:analysis; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000378:metabolism / Q000523:psychology / Q000601:surgery*; D011788:Quality of Life; D012463:Saliva / Q000737:chemistry; D057566:Self Report; D013315:Stress, Psychological / Q000523:psychology
chemical_list: D015850:Interleukin-6; D006854:Hydrocortisone