Study Suggests Link Between Basal Cell Carcinoma, Stressful Life Events, Troubled Early Parent-Child Relationship


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CHICAGO – A study of 91 patients at a university medical center suggests that a troubled early parent-child relationship in combination with a severe life event in the past year may be associated with immune responses to a basal cell carcinoma tumor, the most common skin cancer, according to a report in the June issue of Archives of General Psychiatry, a JAMA Network publication.

Stressful events and their resulting negative emotions can dysregulate (impair) immunity enough to produce clinically significant alterations, and the immune system plays a role in basal cell carcinoma (BCC) tumor appearance and progression, according to the study background. Risk factors for the first BCC include age, childhood sun exposure, fair skin and being male, and the authors note subsequent tumors are not reliably related to those variables.

“The immune system plays a prominent role in response to BCC tumors because they are immunogenic, unlike many other common cancers that do not show the same responsiveness to the immune system,” the authors comment. “Psychological stress may play an important role in the tumor environment for this immunogenic tumor and have important implications for subsequent BCC tumors.”

Christopher P. Fagundes, Ph.D., of  The Ohio State University Medical Center, Columbus, and colleagues collected information about early parent-child experiences, recent severe life events, depression and mRNA (messenger RNA) for immune markers associated with BCC tumor progression and regression from patients with BCC tumors. The patients, 48 men and 43 women, ranged in age from 23 to 92 years and had a previous BCC tumor.

“Our results show that among BCC patients who experienced a severe stressor in the past year, those who were emotionally maltreated by their mothers or fathers as children were more likely to have poorer immune responses as reflected in lower levels of mRNA for CD25, CD3ε, ICAM-1 and CD68 to their BCC tumors,” the authors note.

Emotional maltreatment was not associated with BCC immune responses among those who did not experience a severe life event, and depressive symptoms were not associated with the local tumor immune response, according to study results.

“This is the first study, to our knowledge, to show that troubled early parental experiences, in combination with a severe life event in the past year, predict local immune responses to a BCC tumor. These data complement and expand increasing evidence that the consequences of early parental experiences extend well beyond childhood,” the authors conclude.

(Arch Gen Psychiatry. 2012;69[6]:618-626. Available pre-embargo to the media at


Editor’s Note: The study was supported in part by grants from the National Cancer Institute, the Gilbert and Kathryn Mitchell Endowment, The Ohio State University Comprehensive Cancer Center and the American Center Society. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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