Diurnal cortisol dysregulation, functional disability, and depression in women with ovarian cancer

Abstract

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 3x 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