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Diurnal cortisol dysregulation, functional disability, and depression in women with ovarian cancer.
  • Aliza Z. Weinrib
  • Sandra E. Sephton
  • Koen De Geest, University of Iowa
  • Frank Penedo
  • David P. Bender, University of Iowa
  • Bridget Zimmerman
  • Clemens Kirschbaum
  • Anil K. Sood
  • David M. Lubaroff
  • Susan K. Lutgendorf
Document Type
Peer Reviewed
Publication Date

BACKGROUND: Multiple alterations in circadian rhythms have been observed in cancer patients, including the diurnal rhythm of the adrenal hormone cortisol. Diurnal cortisol alterations have been associated with cancer-related physiological processes as well as psychological stress. Here we investigate alterations in diurnal cortisol rhythm in ovarian cancer patients, and potential links with depression, life stress, and functional disability.

METHODS: Women (n = 177) with suspected ovarian cancer completed questionnaires and collected salivary cortisol 3× daily for 3 consecutive days before surgery. One hundred women were subsequently diagnosed with ovarian cancer and 77 with benign disease. In addition, healthy women (n = 33) not scheduled for surgery collected salivary cortisol at the same time points.

RESULTS: Ovarian cancer patients demonstrated significantly elevated nocturnal cortisol (P = .022) and diminished cortisol variability (P = .023) compared with women with benign disease and with healthy women (all P values

CONCLUSIONS: Nocturnal cortisol and cortisol variability show significant dysregulation in ovarian cancer patients, and this dysregulation was associated with greater functional disability, fatigue, and vegetative depression. These findings suggest potential hypothalamic-pituitary-adrenal involvement in functional disability in ovarian cancer, and may have implications for disease progression.

  • Activities of Daily Living,
  • Aged,
  • Circadian Rhythm,
  • Depression,
  • Fatigue,
  • Female,
  • Health Status,
  • Humans,
  • Hydrocortisone,
  • Middle Aged,
  • Ovarian Neoplasms,
  • Quality of Life,
  • Saliva,
  • Stress,
  • Psychological
Published Article/Book Citation
Cancer (2010) 116:18, pp. 4410-4419.
Citation Information
Aliza Z. Weinrib, Sandra E. Sephton, Koen De Geest, Frank Penedo, et al.. "Diurnal cortisol dysregulation, functional disability, and depression in women with ovarian cancer." Cancer Vol. 116 Iss. 18 (2010) p. 4410 - 4419 ISSN: 0008-543X
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