Correlation Of Psychological Disturbances And Serum Cortisol Level In Lung Cancer

Lung cancer can be conceptualized as a stressor with psychological, behavioral and biological components that can severely impact upon quality of life (QOL). Lung cancer patients generally experience decreased QOL and high levels of psychological distress (Porter L S, 2003). Cortisol is a steroid hormone, more specifically, a glucocorticoid, produced by the zona fasciculate of the adrenal cortex (Scott E, 2011). It is released in response to stress and a low level of blood glucocorticoid. Changed patterns of serum cortisol levels have been observed in connection with abnormal ACTH levels, clinical depression, psychological stress and psychological stressors such as hypoglycemia, illness, fever, trauma, surgery, fear, pain or temperature’s extremes (Vedhara K et al, 2004). The psychology of lung cancer patients is affected by several factors related to the patient, stage of the disease and treatment characteristics. As lung cancer is a life-threatening disease, its Abstract: Introduction: The diagnosis of cancer brings not only emotional distress as a normal response to the catastrophic event the illness represents, but also a series of issues that reflect the patient’s perception of the illness. Changed patterns of serum cortisol level have been observed in connection with abnormal ACTH levels, clinical depression and psychological stress. The study was conducted to assess psychological behavior in lung cancer patients with different stages of diagnosis of lung cancer by using a self-reporting Symptom Check List-90-Revised (SCL-90R).The SCL-90-R consisted 90 questions and each question is rated on five point scale of distress (0-4) ranging from ‘not at all’ at one end to ‘extremely’ at the other end. Serum level of cortisol hormone was also estimated in these patients. Aims: The purpose of the study was to find out correlation between serum cortisol levels and psychological disorders in lung cancer patients. Material and Method: The study was conducted in Upgraded Department of Physiology, S.M.S.Medical College, Jaipur. Total 300 participants, included 150 lung cancer patients (divided in 3 sub groups A, B and C on the basis of their duration from diagnosis of lung cancer) and 150 healthy controls of both sexes were taken in the study. Serum cortisol levels were measured in blood sample collected at 8:30 a.m.±30 min.and Hindi version of Symptom Check List-90-Revised (SCL-90-R) was completed by all the subjects. Results : Severity of psychological disorders and serum cortisol levels were highest in sub group A (recently diagnosed) followed by sub group B(diagnosed between 2 to 4 months) and sub group C (diagnosed for more than 4 months).On application of one way ANOVA test, this difference in severity was found highly significant (P<0.0001) for all the psychological symptoms (except hostility symptom which is non-significant, P<0.05)).The differences in mean of serum cortisol levels in 3 sub groups of lung cancer were highly significant (HS,P<0.0001). In comparison of patients and controls, the mean severity of psychological disorders in patients was higher than controls (P<0.0001, HS).The mean difference in serum cortisol levels in patients and controls was statistically highly significant (P=0.000). Conclusion: Based on the above findings, it may be concluded that lung cancer patients had a high score of psychological disorders which was possibly correlated to serum level of cortisol and duration from the diagnosis of the disease in these patients. A multidisciplinary approach should be taken. Patients should be included for the comprehensive management of the psychological symptoms of the disease.