scholarly journals Is RAS the Link Between COVID-19 and Increased Stress in Head and Neck Cancer Patients?

Author(s):  
Anem Iftikhar ◽  
Mohammad Islam ◽  
Simon Shepherd ◽  
Sarah Jones ◽  
Ian Ellis

The COVID-19 pandemic emerged as a largely unexplained outbreak of pneumonia cases, in Wuhan City, China and rapidly spread across the world. By 11th March 2020, WHO declared it as a global pandemic. The resulting restrictions, to contain its spread, demanded a momentous change in the lifestyle of the general population as well as cancer patients. This augmented negative effects on the mental health of patients with head and neck cancer (HNC), who already battle with the stress of cancer diagnosis and treatment. The causative agent of COVID-19, SARS-CoV2, gains entry through the Angiotensin converting enzyme 2 (ACE2) receptor, which is a component of the Renin Angiotensin System (RAS). RAS has been shown to influence cancer and stress such that it can have progressive and suppressive effects on both. This review provides an overview of SARS-CoV2, looks at how the RAS provides a mechanistic link between stress, cancer and COVID-19 and the probable activation of the RAS axis that increase stress (anxiogenic) and tumor progression (tumorigenic), when ACE2 is hijacked by SARS-CoV2. The mental health crises brought about by this pandemic have been highlighted in many studies. The emerging links between cancer and stress make it more important than ever before to assess the stress burden of cancer patients and expand the strategies for its management.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 43-43
Author(s):  
Natalie Riblet ◽  
Karen Skalla ◽  
Alison Peterson ◽  
Auden McClure ◽  
Karen Homa ◽  
...  

43 Background: To better address the emotional needs of cancer patients by improving mental health care in Head and Neck Cancer (HNC) Medical oncology at Norris Cotton Cancer Center, Lebanon, NH, through implementing an evidence-based process for identifying and managing psychological distress. Methods: Using quality improvement methods, mental health care in HNC Medical Oncology was evaluated and revised November 2010 through April 2012. In January 2011, a two-component intervention was put into routine care including 1) the validated National Comprehensive Cancer Network (NCCN) distress thermometer (DT) and 2) a treatment decision algorithm. A licensed nursing assistant administered the DT and providers reviewed results as part of the clinical exam. Heightened distress was defined as a score of ≥ 4. Screening processes were improved through Plan-Do-Study-Act (PDSA) cycles. Results: Prior to January 2011, identification of distress was based on provider’s clinical assessment. Of 104 patients seen between November 2010 and January 2011, 25% (26) were diagnosed with psychological problems. Cause-effect diagraming suggested that lack of a formalized process for distress assessment contributed to missed diagnoses. Providers were unfamiliar with mental health resources. As reported in Psycho-Oncology 21(Suppl. 1): 51(2012) after implementing process changes, bi-weekly distress screening rates rose from 0% to 38% between January and July 2011. With additional PDSA cycles, these rates increased to 74% between October 2011 and April 2012. Similar to proposed benchmarks, 84% (47) of newly diagnosed patients (56) were assessed for distress. Furthermore, of 138 unique patients seen, 71% (98) were screened for distress and 47% (46) of these had heightened distress. Providers addressed the needs of all those identified. Improvement was attributed to the empowerment of staff and participation of senior leadership. Barriers included a heavy reliance on the presence of trained staff. Conclusions: Quality improvement methods can be applied to the cancer setting in order to create systems of care, which more reliably identify and address distress. Teams, however, must be invested in the work and receive support from senior leadership.


2020 ◽  
pp. 72-73
Author(s):  
Sandeep Ghosh ◽  
Bonny Joseph ◽  
Vinod Dhakad ◽  
Sanjay Desai

WHO declared the COVID-19 outbreak to be a global pandemic on March 11, 2020. We hereby present the ongoing challenges, and the protocol and algorithms followed by us right from diagnosis, surgery and follow up of 50 head and neck cancer patients during the time of covid-19 pandemic at a tertiary care center in central India. Of the 50 head and neck cancer patients operated we had 16(32%) Ca buccal mucosa cases, 13(26%) cases of ca lower alveolus, 9 (18%) ca tongue cases, 5 (10%) ca maxilla, 3 (6%) ca larynx, 2 (4%) ca lip and 2 (4%) ca thyroid cases. It is prudent to consider every patient as covid carrier as community spread has already occurred in our country and take necessary precautions while examining all patients. Cancer Management is semi-emergency. The precautions taken by us are considered to be standard and have allowed us to perform head and neck cancer surgeries safely in this Covid-19 pandemic.


2019 ◽  
Vol 37 (3) ◽  
pp. 301-318
Author(s):  
Diana D. Jeffery ◽  
Lcdr Art Ambrosio ◽  
Laura Hopkins ◽  
Harry B. Burke

Author(s):  
Leonid Bardenshtein ◽  
Valeriy Leontiev ◽  
Aleksey Drobyshev ◽  
Aleksandr Tsimbalistov ◽  
Nikolay Malginov ◽  
...  

The review focuses on depressive disorders in cancer patients. The article summarizes the findings of domestic and foreign studies on depression prevalence, clinical symptoms and treatment in head and neck cancer patients. Early detection of affective disorder and timely administration of antipsychotic drug treatment is shown to be important for this patient category.


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