Correlations between cytokines, depression and anxiety in patients with colorectal cancer in adjuvant and palliative chemotherapy.

Abstract

Colorectal cancer (CRC) is a leading cause of cancer mortality in the world. Depression and anxiety are the most prevalent psychological disorders in patients with CRC. The occurrence of these symptoms impairs the adherence to cancer treatment, the quality of life of patients and increases the burden of health services. Proper management of these disorders is therefore an important issue in oncology nursing practice. Evidences suggesting a role of cytokines in the pathophysiology of depression, combined with the presence of high levels of these molecules in cancer patients suggest that they can play an important role in the etiology and phenomenology of depression and anxiety in these subjects. A holistic understanding of these factors will allow the design of nursing interventions that lead to an improved quality of life and overall survival of patients with CRC. This study aims to investigate whether there is a correlation between anxiety, depression and serum cytokines in patients with colorectal cancer at different times of adjuvant or palliative chemotherapy. To this end, adult patients who underwent surgical resection and are initiating an adjuvant or palliative chemotherapy with capecitabine and oxaliplatin at the Department of Clinical Oncology of HCFMRP/USP will be invited to participate in the study.. Depression and anxiety will be analyzed using the HADS scale (Hospital Anxiety and Depression Scale) and serum levels of IL-1, IL-6, INF-gamma, TNF-alpha, TGF-beta, IL-10 and fractalkine (CX3C) will be measured by ELISA. Comparison between the sample groups will be conducted by ANOVA-F and Kruskal-Wallis test and p values < 0.05 will be considered statistically significant.