Pancreatic cancer and depression: myth and truth

<p>Abstract</p> <p>Background</p> <p>Various studies reported remarkable high incidence rates of depression in cancer patients compared with the general population. Pancreatic cancer is still one of the malignancies with the worst prognosis and therefore it seems quite logical that it is one of the malignancies with the highest incidence rates of major depression.</p> <p>However, what about the scientific background of this relationship? Is depression in patients suffering from pancreatic cancer just due to the confrontation with a life threatening disease and its somatic symptoms or is depression in this particular group of patients a feature of pancreatic cancer per se?</p> <p>Discussion</p> <p>Several studies provide evidence of depression to precede the diagnosis of pancreatic cancer and some studies even blame it for its detrimental influence on survival. The immense impact of emotional distress on quality of life of cancer patients enhances the need for its early diagnosis and adequate treatment. Knowledge about underlying pathophysiological mechanisms is required to provide the optimal therapy.</p> <p>Summary</p> <p>A review of the literature on this issue should reveal which are the facts and what is myth.</p

Paraneoplastic syndromes in pancreatic cancer.

Paraneoplastic syndromes are defined as signs and symptoms which presentdistant to the site of primary cancer or metastases. However, they are closelyassociated with the malignant disease and comprise metabolic, dystrophic, and/ordegenerative symptoms, which are consequences of humoral or hormonal factors. The clinical symptoms vary widely and include systemic and organ-specificmanifestations. In some cases, these can become the major clinical problems determining survival. Systemic manifestations include frequent symptoms ofpancreatic cancer patients such as fever and cachexia. Organ-specific symptomsmay represent as cutaneous, neurological, hematological, or endocrine symptoms. A special focus of this chapter is on diabetes mellitus associated withpancreatic tumors. The best-understood syndromes result from tumor productionof biologically active substances or, to a lesser extent, from autoimmune phenomena. Biological active agents may promote the growth of the tumor directly. In turn, growth-promoting agents of this type may become the focus of newapproaches to anticancer treatment. After successful treatment of the underlyingmalignant disease, paraneoplastic symptoms may resolve completely. Thus, earlyrecognition of paraneoplastic syndromes is very important in the management ofpatients with pancreatic cancer. In the following chapter, the most commonparaneoplastic syndromes are described in detail