Derleme
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Kanserin Nörobiyolojisi: Psikoonkolojik ve Nörobilimsel Perspektiften Bir Derleme

Yıl 2026, Cilt: 18 Sayı: 1, 256 - 267
https://doi.org/10.18863/pgy.1664408

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.

Kaynakça

  • Ahles TA, Root JC (2018) Cognitive effects of cancer and cancer treatments. Annu Rev Clin Psychol, 14:425-451.
  • Beck JS (2020) Cognitive Therapy: Basics and Beyond. New York, Guilford Press.
  • Broadbent DE, Cooper PF, FitzGerald P, Parkes KR (1982) The cognitive failures questionnaire (CFQ) and its correlates. Brit J Clin Psychol, 21:1-16.
  • Carletto S, Pagani M (2016) Neurobiological impact of EMDR in cancer patients. Journal of EMDR Practice and Research, 10:153–161.
  • Cole SW, Nagaraja AS, Lutgendorf, SK, Green PA, Sood AK (2015) Sympathetic nervous system regulation of the tumor microenvironment. Nat Rev Cancer, 15:563-572.
  • Davidson RJ, Kaszniak AW (2015) Conceptual and methodological issues in research on mindfulness and meditation. Am Psychol, 70:581–592.
  • Davidson RJ, McEwen BS (2012) Social influences on neuroplasticity: stress and interventions to promote well-being. Nat Neurosci, 15:689-695
  • Eng JW-L, Kokolus KM, Reed CB, Hylander BL, Ma WW, Repasky EA (2014) A nervous tumor microenvironment: The impact of adrenergic stress on cancer cells, immunosuppression, and immunotherapeutic response. Cancer Immunol Immun, 63: 1115–1128
  • Farina A, Birzu C, Elsensohn MH, Picca A, Muñiz-Castrillo S, Vogrig A et al. (2023) Neurological outcomes in immune checkpoint inhibitor-related neurotoxicity. Brain Commun, 5:fcad169.
  • Fox KC, Nijeboer S, Dixon ML, Floman, JL, Ellamil M, Rumak SP et al. (2014) Is meditation associated with altered brain structure? A systematic review and meta-analysis of morphometric neuroimaging in meditation practitioners. Neurosci Biobehav Rev, 43:48-73.
  • Gotink RA, Meijboom R, Vernooij MW, Smits M, Hunink MM (2016) 8-week mindfulness based stress reduction induces brain changes similar to traditional long-term meditation practice–a systematic review. Brain Cogn, 108:32-41.
  • Goyal M, Singh S, Sibinga EM, Gould NF, Rowland-Seymour A, Sharma R et al. (2014) Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med, 174:357-368.
  • Henneghan A, Rao V, Harrison RA, Karuturi M, Blayney DW, Palesh O, Kesler SR (2020) Cortical brain age from pre-treatment to post-chemotherapy in patients with breast cancer. Neurotox Res, 37:788-799.
  • Joly F, Castel H, Tron L, Lange M, Vardy J (2020) Potential effect of immunotherapy agents on cognitive function in cancer patients. J Natl Cancer I, 112:123-127.
  • Kesler SR, Henneghan, AM, Prinsloo S, Palesh O, Wintermark M (2023) Neuroimaging based biotypes for precision diagnosis and prognosis in cancer-related cognitive impairment. Front Med (Lausanne), 10:1199605.
  • Khan MA, Florou V, Swami U (2021) Immunotherapy and fatigue: what we know and what we don’t know. Oncotarget, 12:719.
  • Labelle LE, Campbell TS, Carlson LE (2010) Mindfulness-based stress reduction in oncology: Evaluating mindfulness and rumination as mediators of change in depressive symptoms. Mindfulness, 1:8-40.
  • Lengacher CA, Reich RR, Paterson CL, Ramesar S, Park JY, Alinat C et al. (2016) Examination of broad symptom improvement resulting from mindfulness-based stress reduction in breast cancer survivors: a randomized controlled trial. J Clin Oncol, 34:2827-2834.
  • Lutgendorf SK, Andersen BL (2015) Biobehavioral approaches to cancer progression and survival: Mechanisms and interventions. Am Psychol, 70:186-197.
  • Monje M, Dietrich J (2012) Cognitive side effects of cancer therapy demonstrate a functional role for adult neurogenesis. Behav Brain Res, 227:376-379.
  • Mravec B (2021) Neurobiology of cancer: ıntroduction of new drugs in the treatment and prevention of cancer. Int J Mol Sci, 22:6115.
  • Pagani MGdL, Verardo A, Nicolais G, Monaco L, Niolu, C et al. (2012) Neurobiological correlates of EMDR therapy. Riv Psichiatr, 47(2 Suppl):16-18.
  • Portigliatti Pomeri A, La Salvia A, Carletto S, Oliva F, Ostacoli L (2021) EMDR in cancer patients: A systematic review. Front Psychol, 11:590204.
  • Sanada K, Alda DM, Salas VM, Pérez-Yus MC, Demarzo MM, Montero-Marín J et al. (2017) Effects of mindfulness-based interventions on biomarkers in healthy and cancer populations: a systematic review. BMC Complement Med Ther, 17:125.
  • Savaş E (2024) WomenCan: CBT interventions for breast cancer patients. Turk J Oncol, 9:22-33.
  • Shao R, Keuper K, Geng X, Egner T (2021) Neuroplasticity associated with mindfulness-based interventions: A systematic review. Neurosci Biobehav Rev, 127:426–438.
  • Shapiro F (2001) Eye Movement Desensitization and Reprocessing (EMDR): Basic Principles, Protocols, and Procedures. New York, Guilford Press
  • Sharpe J, Palettas, M, Grimm M, Kassem M, Ramaswamy B, Wesolowski R et al. (2022) Abstract P4-09-08: Examining neurocognitive function in breast-cancer patients after chemotherapy. Cancer Res J, 82(4_Supplement):P4-09
  • Tang YY, Hölzel BK, Posner MI (2015) The neuroscience of mindfulness meditation. Nat Rev Neurosci, 16:213-225.
  • van der Kolk BA (2014) The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. New York, Viking Press.
  • Wefel JS, Schagen SB (2012) Chemotherapy-related cognitive dysfunction. Curr Neurol Neurosci Rep, 12:267-275.
  • Wong SL (2023) A model for the flash technique based on working memory and neuroscience research. Journal of EMDR Practice and Research, 15:174-184.
  • Yin Q, Wu L, Han L, Zheng X, Tong R, Li L et al. (2023) Immune-related adverse events of immune checkpoint inhibitors: a review. Front Immunol, 14:1167975..
  • Zainal NZ, Booth S, Huppert FA (2013) The efficacy of mindfulness-based stress reduction on mental health of breast cancer patients: A meta-analysis. Psychooncology, 22:1457–1465.
  • Zeidan F, Adler-Neal AL, Wells RE, Stagnaro E, May LM, Eisenach JC et al. (2016) Mindfulness meditation-based pain relief is not mediated by endogenous opioids. J Neurosci, 36:3391-3397.

Neurobiology of Cancer: A Review from Psychooncologic and Neuroscientific Perspective

Yıl 2026, Cilt: 18 Sayı: 1, 256 - 267
https://doi.org/10.18863/pgy.1664408

Öz

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.

Kaynakça

  • Ahles TA, Root JC (2018) Cognitive effects of cancer and cancer treatments. Annu Rev Clin Psychol, 14:425-451.
  • Beck JS (2020) Cognitive Therapy: Basics and Beyond. New York, Guilford Press.
  • Broadbent DE, Cooper PF, FitzGerald P, Parkes KR (1982) The cognitive failures questionnaire (CFQ) and its correlates. Brit J Clin Psychol, 21:1-16.
  • Carletto S, Pagani M (2016) Neurobiological impact of EMDR in cancer patients. Journal of EMDR Practice and Research, 10:153–161.
  • Cole SW, Nagaraja AS, Lutgendorf, SK, Green PA, Sood AK (2015) Sympathetic nervous system regulation of the tumor microenvironment. Nat Rev Cancer, 15:563-572.
  • Davidson RJ, Kaszniak AW (2015) Conceptual and methodological issues in research on mindfulness and meditation. Am Psychol, 70:581–592.
  • Davidson RJ, McEwen BS (2012) Social influences on neuroplasticity: stress and interventions to promote well-being. Nat Neurosci, 15:689-695
  • Eng JW-L, Kokolus KM, Reed CB, Hylander BL, Ma WW, Repasky EA (2014) A nervous tumor microenvironment: The impact of adrenergic stress on cancer cells, immunosuppression, and immunotherapeutic response. Cancer Immunol Immun, 63: 1115–1128
  • Farina A, Birzu C, Elsensohn MH, Picca A, Muñiz-Castrillo S, Vogrig A et al. (2023) Neurological outcomes in immune checkpoint inhibitor-related neurotoxicity. Brain Commun, 5:fcad169.
  • Fox KC, Nijeboer S, Dixon ML, Floman, JL, Ellamil M, Rumak SP et al. (2014) Is meditation associated with altered brain structure? A systematic review and meta-analysis of morphometric neuroimaging in meditation practitioners. Neurosci Biobehav Rev, 43:48-73.
  • Gotink RA, Meijboom R, Vernooij MW, Smits M, Hunink MM (2016) 8-week mindfulness based stress reduction induces brain changes similar to traditional long-term meditation practice–a systematic review. Brain Cogn, 108:32-41.
  • Goyal M, Singh S, Sibinga EM, Gould NF, Rowland-Seymour A, Sharma R et al. (2014) Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med, 174:357-368.
  • Henneghan A, Rao V, Harrison RA, Karuturi M, Blayney DW, Palesh O, Kesler SR (2020) Cortical brain age from pre-treatment to post-chemotherapy in patients with breast cancer. Neurotox Res, 37:788-799.
  • Joly F, Castel H, Tron L, Lange M, Vardy J (2020) Potential effect of immunotherapy agents on cognitive function in cancer patients. J Natl Cancer I, 112:123-127.
  • Kesler SR, Henneghan, AM, Prinsloo S, Palesh O, Wintermark M (2023) Neuroimaging based biotypes for precision diagnosis and prognosis in cancer-related cognitive impairment. Front Med (Lausanne), 10:1199605.
  • Khan MA, Florou V, Swami U (2021) Immunotherapy and fatigue: what we know and what we don’t know. Oncotarget, 12:719.
  • Labelle LE, Campbell TS, Carlson LE (2010) Mindfulness-based stress reduction in oncology: Evaluating mindfulness and rumination as mediators of change in depressive symptoms. Mindfulness, 1:8-40.
  • Lengacher CA, Reich RR, Paterson CL, Ramesar S, Park JY, Alinat C et al. (2016) Examination of broad symptom improvement resulting from mindfulness-based stress reduction in breast cancer survivors: a randomized controlled trial. J Clin Oncol, 34:2827-2834.
  • Lutgendorf SK, Andersen BL (2015) Biobehavioral approaches to cancer progression and survival: Mechanisms and interventions. Am Psychol, 70:186-197.
  • Monje M, Dietrich J (2012) Cognitive side effects of cancer therapy demonstrate a functional role for adult neurogenesis. Behav Brain Res, 227:376-379.
  • Mravec B (2021) Neurobiology of cancer: ıntroduction of new drugs in the treatment and prevention of cancer. Int J Mol Sci, 22:6115.
  • Pagani MGdL, Verardo A, Nicolais G, Monaco L, Niolu, C et al. (2012) Neurobiological correlates of EMDR therapy. Riv Psichiatr, 47(2 Suppl):16-18.
  • Portigliatti Pomeri A, La Salvia A, Carletto S, Oliva F, Ostacoli L (2021) EMDR in cancer patients: A systematic review. Front Psychol, 11:590204.
  • Sanada K, Alda DM, Salas VM, Pérez-Yus MC, Demarzo MM, Montero-Marín J et al. (2017) Effects of mindfulness-based interventions on biomarkers in healthy and cancer populations: a systematic review. BMC Complement Med Ther, 17:125.
  • Savaş E (2024) WomenCan: CBT interventions for breast cancer patients. Turk J Oncol, 9:22-33.
  • Shao R, Keuper K, Geng X, Egner T (2021) Neuroplasticity associated with mindfulness-based interventions: A systematic review. Neurosci Biobehav Rev, 127:426–438.
  • Shapiro F (2001) Eye Movement Desensitization and Reprocessing (EMDR): Basic Principles, Protocols, and Procedures. New York, Guilford Press
  • Sharpe J, Palettas, M, Grimm M, Kassem M, Ramaswamy B, Wesolowski R et al. (2022) Abstract P4-09-08: Examining neurocognitive function in breast-cancer patients after chemotherapy. Cancer Res J, 82(4_Supplement):P4-09
  • Tang YY, Hölzel BK, Posner MI (2015) The neuroscience of mindfulness meditation. Nat Rev Neurosci, 16:213-225.
  • van der Kolk BA (2014) The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. New York, Viking Press.
  • Wefel JS, Schagen SB (2012) Chemotherapy-related cognitive dysfunction. Curr Neurol Neurosci Rep, 12:267-275.
  • Wong SL (2023) A model for the flash technique based on working memory and neuroscience research. Journal of EMDR Practice and Research, 15:174-184.
  • Yin Q, Wu L, Han L, Zheng X, Tong R, Li L et al. (2023) Immune-related adverse events of immune checkpoint inhibitors: a review. Front Immunol, 14:1167975..
  • Zainal NZ, Booth S, Huppert FA (2013) The efficacy of mindfulness-based stress reduction on mental health of breast cancer patients: A meta-analysis. Psychooncology, 22:1457–1465.
  • Zeidan F, Adler-Neal AL, Wells RE, Stagnaro E, May LM, Eisenach JC et al. (2016) Mindfulness meditation-based pain relief is not mediated by endogenous opioids. J Neurosci, 36:3391-3397.
Toplam 35 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Nöropsikoloji, Sağlık Psikolojisi
Bölüm Derleme
Yazarlar

Esra Savaş 0000-0002-8178-6804

Yayımlanma Tarihi 5 Ekim 2025
Gönderilme Tarihi 24 Mart 2025
Kabul Tarihi 20 Mayıs 2025
Yayımlandığı Sayı Yıl 2026 Cilt: 18 Sayı: 1

Kaynak Göster

AMA Savaş E. Neurobiology of Cancer: A Review from Psychooncologic and Neuroscientific Perspective. Psikiyatride Güncel Yaklaşımlar. 18(1):256-267. doi:10.18863/pgy.1664408

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