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Psychooncology
and cancer progression-related alterations of pleasure-associated neurochemical
system: Abnormal neuroendocrine response to apomorphine in advanced cancer
patients
Lissoni P, Malugani F, Manganini V, Ardizzoia A, Gardani G,
Bartolacelli E, Messina G, Tancini G
Division of
Radiation Oncology, St Gerardo Hospital, 20052 Monza, Milan, ITALY
Objectives. The clinical approach of the Psychooncology is generally
limited to the investigation of the only psychological status of cancer
patients, without taking into consideration the well demonstrated cancer
progression-related psychoneuroendocrine alterations, namely consisting of a
progressive decline in the pineal endocrine function and an anomalous activity
of brain opioid system.
The endocrine response to apomorphine, a dopaminergic agent, has been proven to
reflect the dopaminergic sensitivity, which would be involved at least in part
in pleasure-related neurochemical mechanisms.
The present study was performed to analyze the endocrine response to apomorphine
in metastatic cancer patients, as a preliminary approach to the investigation of
pleasure-related neuroendocrine mechanisms in human neoplasms.
Materials
& Methods. The study included 10 metastatic cancer male patients and 6
male volunteers as a control group.
Apomorphine was given orally at 0.01 mg/kg body weight in the morning, and
venous blood samples were collected before, and at 20, 60 and 120 minutes after
apomorphine administration.
The endocrine analysis consisted of the measurement of serum levels of GH, PRL
and cortisol.
Results.
All cancer patients presented alterations involving one or more endocrine
responses to apomorphine.
GH and cortisol mean levels after apomorphine were significantly higher in
controls than in cancer patients, whereas no substantial difference occurred in
those of PRL.
Conclusions.
This preliminary study, by showing an altered endocrine response to apomorphine
in metastatic cancer patients, would suggest that cancer progression may be
associated with an altered dopaminergic sensitivity.
Because of the involvement of the dopaminergic system in pleasure-related
neurochemical mechanisms, this finding would demonstrated that the decline in
the perception of pleasure with cancer progression may depend not only on
psychological factors, but also, at least in part, on psychochemical alterations
occurring during the clinical course of the neoplastic disease.
PMID: 12743532 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12743532&dopt=Abstract
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