Kanserin Nörobiyolojisi: Psikoonkolojik ve Nörobilimsel Perspektiften Bir Derleme

Öz

Bu derleme çalışması, kanserin yalnızca biyolojik değil, aynı zamanda psikolojik ve nörobiyolojik yönleriyle de anlaşılması gerektiğini vurgulamaktadır. Psikososyal stres, depresyon ve sosyal izolasyon gibi etkenlerin nöroendokrin sistem ve bağışıklık sistemi aracılığıyla kanserin başlangıcı ve ilerleyişi üzerinde önemli etkileri bulunmaktadır. Bu bağlamda, sinir sistemi ile bağışıklık sistemi arasındaki etkileşimlerin tümör mikroçevresi, nöroinflamasyon ve nörotransmitter düzeyleri üzerindeki etkileri detaylandırılmıştır. Ayrıca, kanser tedavilerinin (kemoterapi, radyoterapi, hormon tedavisi, immünoterapi) bilişsel ve duygusal işlevler üzerindeki nörobiyolojik etkileri ele alınmış; “kemobeyin”, nöropatik ağrı ve tedaviye bağlı nörokognitif bozulmalar açıklanmıştır. Son yıllarda yapılan araştırmalar, Kognitif Davranışçı Terapi, Göz Hareketleriyle Duyarsızlaştırma ve Yeniden İşleme Terapisi ve mindfulness gibi psikoonkolojik yaklaşımlarla bu etkilerin azaltılabildiğini ortaya koymaktadır. Bu müdahalelerin stres yanıtlarını düzenleyerek nöroplastisiteyi desteklediği ve beyin bölgeleri üzerindeki etkilerinin nörogörüntüleme çalışmalarıyla desteklendiği belirtilmiştir. Son olarak, nöropsikolojik değerlendirmeler ve bilişsel rehabilitasyon programlarının bireyselleştirilmiş müdahale süreçlerinde oynadığı kritik rol vurgulanmış, disiplinlerarası yaklaşımın önemi ortaya konmuştur. Bu çalışma, kanserin nörobiyolojik ve psikoonkolojik etkilerini kapsamlı biçimde inceleyerek, mevcut literatürü eleştirel biçimde değerlendirmeyi ve araştırma alanındaki boşluklara dikkat çekmeyi amaçlamaktadır.

Anahtar Kelimeler

• kanser
• nörobiyoloji
• bilişsel bozukluk
• psikoonkoloji
• nöropsikoterapi

Neurobiology of Cancer: A Review from Psychooncologic and Neuroscientific Perspective

Abstract

This review emphasizes the need to understand not only the biological but also the psychological and neurobiological aspects of cancer. Factors such as psychosocial stress, depression and social isolation have important effects on cancer initiation and progression through the neuroendocrine system and the immune system. In this context, the effects of interactions between the nervous system and the immune system on the tumor microenvironment, neuroinflammation and neurotransmitter levels are detailed. In addition, the neurobiological effects of cancer treatments (chemotherapy, radiotherapy, hormone therapy, immunotherapy) on cognitive and emotional functions were discussed; “chemobrain”, neuropathic pain and treatment-related neurocognitive impairments were explained. Recent research has shown that these effects can be mitigated by psychooncological approaches such as Cognitive Behavioral Therapy, Eye Movement Desensitization and Reprocessing Therapy and mindfulness. These interventions support neuroplasticity by regulating stress responses and their effects on brain regions are supported by neuroimaging studies. Finally, the critical role of neuropsychological assessments and cognitive rehabilitation programs in individualized intervention processes was emphasized and the importance of an interdisciplinary approach was revealed. This study aims to critically evaluate the existing literature and draw attention to the gaps in the research field by comprehensively examining the neurobiological and psychooncological effects of cancer.

Keywords

• cancer
• neurobiology
• cognitive impairment
• psycho-oncology
• neuropsychotherapy

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