Digest №6: How Cancer Survival, Social Support, Inflammation, and Depression Interconnect

Bless!

You'll certainly find it interesting out of general curiosity, that there is a very real biological connexion between social support, inflammation, and depression as it relates to cancer survival. As a cancer patient, I trust you'll find it even more interesting, as its understanding can enable you to improve both your quality and duration of life.

First, I think we should establish (or remind ourselves about) the connexion between inflammation and cancer survival.

For this we must understand, that not all inflammation is created equal. Inflammation is ordinarily a protective reaction, which is triggered by injury, infection, or other irritation. The primary job of inflammation hereby is to recruit the appropriate immune cells to the inflamed site, whereby inflammatory cytokines (cell-cell signallers) act as important communication media for these immune cells and enable them to adapt and change their response in accordance with biological need.¹

This interplay between inflammation and immune cells is essential to the proper removal of infections and repair of injuries. The immune system can hereby – depending on inflammatory profile – be functionally polarised to destroy infected and defective cells and act in strict control of infections (henceforth 'seek-and-destroy') or to repair tissue scaffolding and aid in the repopulation of depopulated scaffolding with new healthy cells ('mend-and-repair').

The seek-and-destroy polarisation can hereby leave tissues derelict and lead to organ failure and death, such as seen in deaths from COVID-19, which often occurred due to 'cytokine storms'.² Such cytokine storms are nothing, but an inflammatory reaction gone out of control overstimulating the seek-and-destroy polarisation of the immune system, which in turn leads to an uncontrolled killing of essential cells at a higher rate than they can be replaced.

It's obvious, why such an imbalance must be avoided.

Vitamins A and D₃ are essential to stopping such imbalance from occurring.^3–5 The reason behind this is probably that both these vitamins are central to the ability of our immune system to modulates its activity quickly in order to maintain sufficient seek-and-destroy activity without overburdening our tissues.⁶

For example, vitamin D₃ is necessary both for the effective activation of precision immune cells, which can efficiently kill off infected and defective cells, and for the deactivation of the same precision immune cells once their killing activity is no longer necessary.

Bringing this back to cancer, I'd reckon it should be interesting to you, that precisely those inflammatory cytokines implicated in COVID-19 cytokine storms are oftentimes highly over-expressed in cancer patients.^2,7

Interestingly, in cancer patients they don't seem to cause organ failure and death directly, but cause the seek-and-destroy polarisation to be lost in favour of the mend-and-repair polarisation. This paradoxical mend-and-repair re-polarisation probably happens due to lower cytokine levels than seen in deadly cytokine storms and due to the chronic nature of the over-expression of these cytokines.^8–9

What we'd really like is for this inflammatory signalling to occur in a balanced way, instead of an over-activation of either the mend-and-repair or the seek-and-destroy polarisation. In cancer patients, we want to have powerful anti-tumour seek-and-destroy activity, but still sufficient mend-and-repair activity in surrounding healthy tissues damaged by the tumour.

Cool, so how does this connect to social support and depression?

Fascinatingly, the entirely subjective satisfaction with the social support a cancer patient perceives is correlated significantly with lower levels of those cytokines normally elevated in cancer patients and with longer patient survival.¹⁰ This is probably due to the fact, that lower levels of these specific cytokines allow for better anti-cancer immune activity.

Now, one caveat to this straight-forward connexion between social support and cancer survival comes from the fact, that those same cytokines are also implicated in depression.¹¹

This means, that whilst lower levels of these cytokines almost certainly lead to better cancer patient outcomes, it's not entirely certain that these levels of cytokines are actively lowered by better social support and less depression. It could just as well be, that lower levels of these cytokines give rise to happier, less depressed patients, who because of this better mood incidentally perceive better satisfaction with their social support.

I find this latter analysis most likely, but more data is needed to draw a final conclusion.

In any case, we can use these findings on the importance of these cytokines and their proper modulation to help you live a longer and better life, for we can actually modulate the level and signalling strength of such cytokines pharmacologically.

This is something we've done successfully in one patient suffering from highly increased IL-6 (one of the important cytokines), as can be seen in the anecdotal report we've published some time ago.¹²

I hope this has given you some new perspective and has empowered you to deal more effectively with your disease. Sadly, I can't make sweeping recommendations for interventions, as these must be tailored to every patient's specific inflammatory cytokine profile.

God bless, Merlin L. Marquard

P.S.: Should you ever need help, you know where to reach us.

In other news, we've published an article on how dancing (and other exercise) can help patients live longer and better lives. It touches on some of the same points as this digest, but goes far more in depth on exercise.