Endocrine levels at the start of treatment are associated with subsequent psychological adjustment in cancer patients with metastatic disease

Objective: This study examined the association between hormonal profiles at the start of cancer treatment and subsequent psychological symptomatology. Methods: Twenty-seven patients with metastatic renal cell carcinoma and 18 patients with metastatic melanoma completed three assessments during the c ourse of treatment: at the start of treatment (baseline), at the end of tre atment (3 weeks after baseline), and at a follow-up appointment 1 month lat er. Cortisol, norepinephrine, and epinephrine levels were measured at basel ine using 15-hour urine samples. At each assessment, patients completed the Impact of Event Scale (IES) and the Brief Symptom Inventory (BSI). Results : Patients reported moderate levels of distress throughout treatment as mea sured by the IES and BSI. Norepinephrine levels at the start of treatment w ere positively associated with IES total scores at the end of treatment and at follow-Lip, and cortisol levels were positively associated with IES tot al scores at follow-up after adjusting for baseline IES and overall distres s scores. Norepinephrine levels were also positively associated with depres sion scores at follow-up, and cortisol levels were positively associated wi th depression scores at the end of treatment and at follow-up after adjusti ng for baseline depression and overall distress scores. Conclusions: Hormon al profiles at the start of cancer treatment are associated with subsequent psychological adjustment.