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[Psychological stress in oncology: the role of glucocorticoids].
Bull Cancer 2006; 93(7):699-708BC

Abstract

During the last years, the correlations between biological processes, psychological adjustment and stress disorders have received increasing attention and a growing body of research results has been published in the general literature. In the realm of psycho-oncology, however, conceptual models on this topic and studies aimed at their validation have remained relatively scanty. On the basis of our observations and available literature in the field of post-traumatic and depressive stress disorders in oncology, we have proposed to apply the concept of allostatic load to the study and understanding of the psychological experience of cancer. This strategy has led us to the formulation of a novel classification of adjustment disorders in oncology and the creation of the clinical entity named "cancer-specific stress syndrome". Depending on clinical presentation of the syndrome, one distinguishes three subtypes, namely the depressive, post-traumatic and "dysallostatic" (mixed) forms. In the present paper, we examine the role of glucocorticoids and their relationships with one of the basic components of allostatic load--a failure to counter-regulate the immune system by the hypothalamic-pituitary-adrenal axis--in the physiopathology of stress disorders in oncology. Conflicting theories are presented--glucocorticoid cascade versus insufficient glucocorticoid signal transmission--and studies measuring potential correlations between stress and cortisol in oncology are critically reviewed. The results of this process provide substantial support for the application of the allostatic load model and post-traumatic phenomenology, but important advances have yet to be achieved before definitive conclusions can be established in this field. Such advances could lead to profound changes in the way we understand and treat psychological distress in patients with cancer, both pharmacologically and psychotherapeutically.

Authors+Show Affiliations

Psychiatre, Institut Jules-Bordet, Clinique de Psycho-Oncologie, 121, boulevard de Waterloo, 1000 Bruxelles. alain.ronson@bordet.be

Pub Type(s)

English Abstract
Journal Article
Review

Language

fre

PubMed ID

16873079

Citation

Ronson, Alain. "[Psychological Stress in Oncology: the Role of Glucocorticoids]." Bulletin Du Cancer, vol. 93, no. 7, 2006, pp. 699-708.
Ronson A. [Psychological stress in oncology: the role of glucocorticoids]. Bull Cancer. 2006;93(7):699-708.
Ronson, A. (2006). [Psychological stress in oncology: the role of glucocorticoids]. Bulletin Du Cancer, 93(7), pp. 699-708.
Ronson A. [Psychological Stress in Oncology: the Role of Glucocorticoids]. Bull Cancer. 2006;93(7):699-708. PubMed PMID: 16873079.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Psychological stress in oncology: the role of glucocorticoids]. A1 - Ronson,Alain, PY - 2006/02/01/received PY - 2006/02/28/accepted PY - 2006/7/29/pubmed PY - 2006/8/9/medline PY - 2006/7/29/entrez SP - 699 EP - 708 JF - Bulletin du cancer JO - Bull Cancer VL - 93 IS - 7 N2 - During the last years, the correlations between biological processes, psychological adjustment and stress disorders have received increasing attention and a growing body of research results has been published in the general literature. In the realm of psycho-oncology, however, conceptual models on this topic and studies aimed at their validation have remained relatively scanty. On the basis of our observations and available literature in the field of post-traumatic and depressive stress disorders in oncology, we have proposed to apply the concept of allostatic load to the study and understanding of the psychological experience of cancer. This strategy has led us to the formulation of a novel classification of adjustment disorders in oncology and the creation of the clinical entity named "cancer-specific stress syndrome". Depending on clinical presentation of the syndrome, one distinguishes three subtypes, namely the depressive, post-traumatic and "dysallostatic" (mixed) forms. In the present paper, we examine the role of glucocorticoids and their relationships with one of the basic components of allostatic load--a failure to counter-regulate the immune system by the hypothalamic-pituitary-adrenal axis--in the physiopathology of stress disorders in oncology. Conflicting theories are presented--glucocorticoid cascade versus insufficient glucocorticoid signal transmission--and studies measuring potential correlations between stress and cortisol in oncology are critically reviewed. The results of this process provide substantial support for the application of the allostatic load model and post-traumatic phenomenology, but important advances have yet to be achieved before definitive conclusions can be established in this field. Such advances could lead to profound changes in the way we understand and treat psychological distress in patients with cancer, both pharmacologically and psychotherapeutically. SN - 1769-6917 UR - https://www.unboundmedicine.com/medline/citation/16873079/[Psychological_stress_in_oncology:_the_role_of_glucocorticoids]_ L2 - http://www.jle.com/medline.md?issn=0007-4551&vol=93&iss=7&page=699 DB - PRIME DP - Unbound Medicine ER -