Breast cancer and social environment: getting by with a little help from our friends.
Breast cancer and social environment: getting by with a little help from our friends.
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DOI：
10.1186/s13058-016-0700-x
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发表时间：
2016-05-26
期刊：
影响因子：
--
通讯作者：
DeVries AC
中科院分区：
文献类型：
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作者：
Hinzey A;Gaudier-Diaz MM;Lustberg MB;DeVries AC
社会环境是公认的健康和福祉的决定因素。在乳腺癌患者中，社会支持不足与癌症相关死亡率大幅增加有关。一种常见的解释是，由于工具性支持（即满足治疗需求的援助）减少，社会孤立的个体的情况变得更糟。然而，在啮齿类动物中复制社会隔离对乳腺肿瘤生长的有害影响的能力强烈表明了另一种解释。即，社会孤立的个体具有促进肿瘤生长的生理环境。这篇综述总结了支持社会对乳腺癌影响的临床和基础科学文献，并为这些影响提供了概念性的生理框架。我们认为，社会环境导致乳腺癌幸存者预后存在巨大的个体差异，因为社会环境能够改变基本的生理过程，进而调节肿瘤的生长。了解社会环境在乳腺癌进展中的作用可以促进识别不良结果风险增加的患者。此外，对潜在生理机制的表征可能会导致有针对性地破坏促进社会孤立个体肿瘤进展的有害途径，或利用通过社会参与激活的保护途径作为当代治疗的新治疗补充。
Social environment is a well-recognized determinant in health and wellbeing. Among breast cancer patients, inadequate social support is associated with a substantial increase in cancer-related mortality. A common explanation is that socially isolated individuals fare worse due to reduced instrumental support (i.e., assistance meeting the demands of treatment). However, the ability to replicate the detrimental effects of social isolation on mammary tumor growth in rodents strongly suggests an alternative explanation; i.e., socially isolated individuals have a physiological milieu that promotes tumor growth. This review summarizes the clinical and basic science literature supporting social influences on breast cancer, and provides a conceptual physiological framework for these effects. We propose that social environment contributes to the vast individual differences in prognosis among breast cancer survivors because social environment is capable of altering basic physiological processes, which in turn can modulate tumor growth. Appreciation of the role of social environment in breast cancer progression could promote the identification of patients at increased risk for poor outcomes. In addition, characterization of the underlying physiological mechanisms could lead to targeted disruption of detrimental pathways that promote tumor progression in socially isolated individuals, or exploitation of protective pathways activated through social engagement as novel therapeutic complements to contemporary treatments.