Somebody once rightly said, “Cancer didn’t bring me to my knees, it brought me to my feet”.
Many doctors encourage their patients to seek out a therapist after cancer diagnosis. Psychosocial factors, as well as psychosocial interventions, have now become issues for study in relationship to cancer onset, quality of life, and length of survival. It is now documented that emotional expression, social supports, lower levels of emotional distress, and a fighting spirit tend to be associated with improved survival time in cancer patients. It would therefore be reasonable to expect that psychotherapeutic interventions that address these issues might improve quality of life, decrease level of stress, and improve survival time for cancer patients. The presence of psychiatric co-morbidities significantly affects the patients’ survival rates and are associated with a delay in cancer diagnosis. Furthermore, patients with a psychiatric co-morbidity often do not receive standard cancer treatments such as surgery, chemotherapy, and radiation therapy.
Science and psychology
Why exactly do patients need psychiatric guidance? How could talking to someone help prevent a relapse or result in improved survival? The scientific term to describe speaking your heart out would mean biochemical changes at the epigenetic level resulting in a positive outcome for the body as whole. In a movie released in 2009-, “Love Happens” the lead actor plays the role of a guru and asks his patients to confront their pain. This movie perfectly demonstrates the power of self-healing from a patient’s perspective. On the scientific front however, the book written by Dr.Joe Dispenza –, “You are the Placebo” describes the involvement of epigenetics in these non-conventional therapies. He describes how our genes do not doom us and that same genes can have different outcomes. Coming to think of it at a very specific level related to my field of work- how can two melanoma patients diagnosed with the same BRAF/NRAS mutations at the same stage and time respond differently to treatment might ring a bell at the epigenetic corner since the disease is same genetically.
Where is the problem?
Despite the popularity and demand of psychotherapy, both patients and oncologists report being moderately to very satisfied with the results of psychological therapy. These interventions are not equally effective in all individuals. Sometimes, talking alone is not enough to stimulate those biochemical changes mentioned above. At this point, scientific intervention can come to aid. For decades, scientists have been engaged in dissecting the origins of human cancer and their relative roles of genetic versus epigenetic abnormalities. Epigenetics is defined as mitotically and meiotically heritable changes in DNA gene expression that are not accompanied by changes in DNA sequence.
Can zebrafish provide solution?
The treatment of melanoma has been revolutionized by new therapies targeting MAPK signalling or the immune system however, the cause of resistance remains largely unexplained. The importance of epigenetic factors targeting histones and histone modifiers in driving the behaviour of melanoma is only starting to be revealed and provides significant opportunities to combat the problems of therapeutic resistance. In my project, I utilize zebrafish melanoma model to monitor and understand the temporal epigenetic changes that occur in a normalized tissue from the time of tumor initiation leading to its expansion. Furthermore, to answer the question as to why a tumor becomes resistant to therapy the zebrafish bearing melanoma will be induced with selection pressure by various drug treatments in order to create resistant tumors within the study group. The fact that tumor material can be harvested at very well defined stages of the disease in a zebrafish melanoma model allows for observing the global epigenetic changes with special emphasis on histone marks before and after melanoma onset in addition to before, during and after treatment with specific drugs. The comparison in epigenetic patterns of the zebrafish melanoma that become resistant upon drug treatment to those that remain sensitive might be insightful in finding mechanisms of treatment resistance. This study undoubtedly provides a platform for answering some vital questions on melanoma utilizing the effectiveness of zebrafish.
-Pschodynamic Psychotherapy for Cancer Patients:Norman Straker
-Psychotherapy for cancer patients-SAGE Journals
-Histone Modifications,Modifiers and Readers in melanoma Resistance to Targeted anfd Immune Therapy: Stuart J Gallagher, Jessamy C Tiffen and Peter Hersey, Leonard I.Zon