Treating Beyond the Tumors | May Editor’s Choice

By Zachary Friedrich | Senior Editor

Illustration by: Michelle Shi | Director of Art & Layout

Paul Kalanithi was just short of finishing his training as a neurosurgeon when he received his diagnosis. Suddenly the future doctor and father-to-be became a patient fighting for his life. In his memoir, When Breath Becomes Air, he painfully describes coming to terms with his fate:
“I began to realize that coming in such close contact with my own mortality had changed both nothing and everything. Before my cancer was diagnosed, I knew that someday I would die, but I didn’t know when. After the diagnosis, I knew that someday I would die, but I didn’t know when. But now I knew it acutely. The problem wasn’t really a scientific one. The fact of death is unsettling. Yet there is no other way to live.” (2016)
Paul passed away at age 37 in March of 2015.

In 2018, approximately 1,735,350 people will be diagnosed with cancer in the U.S. alone (American Cancer Society). For these unfortunate people, staying optimistic throughout treatment will be indescribably difficult, but interventions involving medical staff and the patient’s family members and friends can help. Sameer Khan’s Fall 2016 Medical Dialogue Review (MDR) article entitled “The Importance of Psycho-Oncology” does a good job of conveying just that: the necessity of providing psychological assistance to cancer patients. Khan discusses many of the options available to cancer patients with regard to psychiatric and psychological care, as well as the many potential reasons patients forego these options. As an example, support group sessions can enhance cancer patients’ all-around quality of life and renew their hope, but often patients do not make use of them since they are afraid to meet other cancer patients in worse condition, perhaps worsening their anxiety about cancer (Khan, 2016). In fact, only about 59% of cancer patients with depression and/or anxiety, which commonly occur in cancer patients, receive any kind of treatment for their mental illness. While this is greater than the 27% of the general population with depression and/or anxiety that access treatment (Nakash et al., 2014), there is certainly a need for improvement across the board.

There is even evidence to suggest that cancer patients’ odds of surviving decreases if they have depression. A meta-analysis found a slight increase in the mortality of cancer patients with depression, but no differences in the progression of their cancer (Satin, Linden, & Phillips, 2009). It is worth noting that while the meta-analysis found no relationship between depression and cancer progression, there were only three relevant papers to analyze. It is still likely that further studies would reveal such a relationship, especially considering that chronic stress has been found to contribute to cancer progression in mice (Thaker et al., 2006).

A number of models have been proposed to explain depression’s effects on cancer patients. One such model posits a link between behavioral and biological pathways. Depression is characterized by maladaptive activation of the hypothalamopituitary-adrenal (HPA) axis. This compromises the patient’s cellular immune system, leading to dysregulation of the production and function of inflammatory molecules called cytokines. The progression of malignant tumors could be accelerated by the increased production of pro-inflammatory cytokines and modulation of anti-inflammatory cytokines caused by depression (Satin et al., 2009).

Regardless of the explanation for the likely relationship between cancer mortality and depression, alleviating depression in cancer patients should be an important part of treatment. Medicine’s job goes beyond simply treating the physical ailments of the body. In the words of Paul Kalanithi,
“The physician’s duty is not to stave off death or return patients to their old lives, but to take into our arms a patient and family whose lives have disintegrated and work until they can stand back up and face, and make sense of, their own existence.” (2016)
This sentiment could not be more true in the case of cancer patients and their families, whose lives have been violently redefined by a sudden terminal illness.

Works Cited:
American Cancer Society. Cancer Statistics Center. Retrieved from Accessed April 22, 2014.

Kalanithi, P. (2016) When Breath Becomes Air. New York, NY: Random House.

Khan, S. (2016). The Importance of Psycho-Oncology. Medical Dialogue Review, 11(1), 23-25.

Nakash, O., Levav, I., Aguilar-Gaxiola, S., Alonso, J., Andrade, L., H., Angermeyer, M. C., … Scott, K. M. (2014). Comorbidity of common mental disorders with cancer and their treatment gap: Findings from the World Mental Health Surveys. Psychooncology, 23(1), 40-51.

Satin, J. R., Linden, W., & Phillips, M. J. (2009). Depression as a Predictor of Disease Progression and Mortality in Cancer Patients. Cancer, 115(22), 5349-61.

Thaker, P. H., Han, L. Y., Kamat, A. A., Arevalo, J. M., Takahashi, R.., Lu, C., … Sood, A. K. (2006). Chronic stress promotes tumor growth and angiogenesis in a mouse model of ovarian carcinoma. Nature Medicine, 12(18), 939-944.

Input your search keywords and press Enter.

how much cbd is in hemp oil cbd oil wikipedia cbd oil for diabetic neuropathy can cbd make you tired cbd pizza cbd oil soluability dmso cbd oil weight gain dc cbd oil where to buy cbd oil in portland best cbd oil for elderly high cbd indica hire car sydney cbd cbd pharma cbd for libido pure cbd strains cbd fda xanax and cbd cbd leaf cbd lube oil goldline cbd gummies review what does tincture mean in cbd cbd horses best cbd to thc ratio for sleep arizona cbd oil cbd oil distributor how to find a reputable cbd oil cbd oil sleep study cbd poster who dispenses cbd oil near me cbd oil order online us kilo per gallon of cbd oil buy wholesale cbd isolate cannabis oil extract for sale nuleaf cbd reviews

weight loss drug phen most effective weight loss pills at gnc weight loss pills kidney transplant fast easy weight loss pills weekly diets to lose weight fast training diet to lose weight green smoothie diet recipe for weight loss keto diet cancer recipes weight loss atkins diet weight loss for beginners the diet plan licorice root pills fasting weight loss results capsaicin pepper pills weight loss web md what diet pill is the best to loss weight basic diet to lose weight fast keto diet 7 day meal plan diet sodas and weight loss weight loss pills c135 non drug cobie smulders weight loss diet weight loss overnight pills dietitian help with weight loss dr oz top weight loss pills diet for diabetics type 2 how to lose weight miso diet weight loss red pills for weight loss diet point weight loss app dietary restrictions percent weight loss diet challenge diabetic weight loss diet plans type 2 best diet pill for weight loss weight loss diet plan for women low carb how to ask dr about weight loss pills one week diet plan for weight loss indian food mega keto diet pills shark tank lose weight fast free no pills shark tank weight loss pill episode 2020

vape popcorn lung vapor barrier for crawl spaces vape news magazine coolest box mods vaping mod parts oil vape ecig storage box eco vape juice ecig cloud vape escape luling zking ecig best starter kit e cigarette law does vaping weed smell e cigarette mod tank womens vapormax best rechargeable e cigarette uk how to clean vaporizers igo3 e cigarette box mod chips how to use e cig uwell crown new coil low wattage vaping vapor barrier in crawl space aspire mod kits smok rolo badge not working aspire pen vaping ban fda uwell crown tank atomizer voopoo drag device magnets voopoo uforce u2 coil material voopoo too resin voopoo drag 157w gene chip mod vape pen battery walmart

x male enhancement penis enlarger condom sx pills male enhancement super hard pills directions diamond male enhancement review party drugs list xanogen and hgh male enhancement best l arginine supplement for ed quality of life after penis enlargement rhino 3k male enhancement pill wild sex pills any pills for bigger flaccid penis green capsule pills using male enhancement pills to masturbate ed medicine reviews sex without ed pills red the male enhancement pill fda tainted supplements progenix male enhancement prescription medicine for energy natural male enhancer elephant surgical penile enlargements cost best sex pills men hair restoration pills jaguar sex pills do penis enlargement surgeries work rhino rush 60 sex pills safest penis enlargement viagra and prostate enlargement penis enlargement surgeries male enhancement pills that has fast acting sex enhancement hypnosis howard stern show prank call penis pills weight gaining pills gnc