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H. Hardardottir
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P1.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 233)
- Event: WCLC 2015
- Type: Poster
- Track: Biology, Pathology, and Molecular Testing
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.04-073 - The Role of the Stress-Response to a Lung Cancer Diagnosis in Disease Progression (ID 2661)
09:30 - 09:30 | Author(s): H. Hardardottir
- Abstract
Background:
Receiving a cancer diagnosis, particularly of lung cancer, has been shown to increase psychological and biological stress responses and the immediate risks of extreme adverse health outcomes, such as suicide and cardiovascular deaths. Data are scarce on the potential influence of this diagnosis on tumor progression. Prior studies lend suggestive evidence for an association of psychobiological stress-responses on lung cancer progression. The aim of this study is to improve understanding of determinants of the stress-response to a lung cancer diagnosis and explore potential role of this response in disease progression and survival.
Methods:
We have initiated a nationwide prospective cohort study of Icelandic lung cancer patients with a comprehensive questionnaire and biomarker measures of stress, as well as detailed documentation of clinical parameters and disease course. Eligible are all individuals diagnosed with lung cancer at Landspitali University Hospital in Iceland. The aim is to recruit 300 patients over a three year period between 2015 and 2017. Patients with clinical or radigraphic changes suggestive of lung cancer are referred to our hospital. They go through a diagnostic work-up, leading to a definite lung cancer diagnosis and staging during a 24 hour diagnostic course or within few days thereafter. Assessment of psychological stress and relevant biomarkers are integrated with clinical assessments at two time points, i.e. during the diagnostic work-up and at follow-up visit 1-3 weeks later (before treatment). The study participation involves questionnaire assessment of symptoms of anxiety, depression, posttraumatic stress, sleep disturbances and quality of life. Biomarker repositories include overnight urine collection, diurnal saliva and hair sampling for analysis of cortisol and catecholamines along with ECG to determine heart rate variability. Bronchoscopic and core needle biopsies as well as surgical tumor samples will be used for assessment of apoptosis, proliferation, microvascular density and adrenoreceptors expression. Radiographic progression will be assessed at baseline and every 6 months from diagnosis along with complete documentation of clinical parameters, disease course and survival.
Results:
In 4 weeks we have recruited 8 patients (80% acceptance rate). We will characterize determinants of a severe psychological-, neuro-endocrine- and cardiovascular stress-response to a cancer diagnosis, as well as the potential relevance of these responses on tumor characteristics, radiographic progression and disease-specific survival. We expect to present preliminary results from approximately 30 patients at the conference.
Conclusion:
Significance: This research program is the first comprehensive attempt to evaluate determinants of psychobiological-induced responses to a lung cancer diagnosis and their potential impact on cancer progression. The findings might guide intervention strategies to improve quality of life, reduce morbidity and prolong survival in lung cancer patients.
