Sympathetic nervous system (SNS) activity is frequently elevated in cancer patients. Tumor growth and poorer clinical and psychological outcomes have been linked to a dysregulation in the production of stress-related catecholamines, such as norepinephrine (NE) and adrenaline (EPI). Patients with oral cancer experience severe physical and psychological stress throughout diagnosis and treatment.
According to recent research, these patients frequently have far greater plasma catecholamine concentrations than people in good health. These enhanced stress hormones are tightly connected to aggressive clinical features and psychological discomfort, underlining crucial neuroendocrine connections in oncology. Nevertheless, little research has been done on the systemic secretion profile of NE and EPI and their predictors in oral cancer patients. Thus, this study examines the role of NE and EPI in oral cancer.
The current investigation examined the relationship between demographic, clinicopathological, biobehavioral, and psychological factors and plasma NE and EPI levels in 168 patients with oral squamous cell carcinoma (OSCC). Patients with oral cancer had their catecholamine levels compared to those of healthy people and patients with oral leukoplakia. High Performance Liquid Chromatography with Electrochemical Detection (HPLC-ED) was used to quantify the amounts of NE and EPI in plasma. The Brunel Mood Scale (BRUMS) was used to measure psychological mood states and emotional symptoms.
Patients with OSCC had substantially greater systemic NE concentrations than both healthy volunteers (p = 0.003) and patients with oral leukoplakia (p < 0.001). Increased plasma EPI levels were also seen in OSCC patients, however this finding did not approach significance after controlling for variables (p = 0.098) and was impacted by tobacco use (p = 0.018).
The mood descriptors "anger" and "alert" were found to be predictive factors for elevated NE plasma levels in OSCC patients by multivariate analyses (β = 0.260, SE = 0.117, p = 0.028 and β = 0.151, SE = 0.073, p = 0.004, respectively). No variable was linked with EPI plasma levels in OSCC patients.
Overall, the findings show that patients with oral cancer have greater systemic concentrations of stress-related catecholamines and that the emotional feelings of anger and alertness are linked to higher norepinephrine levels. Monitoring stress-related biomarkers may help better assess and manage psychological symptoms in patients with oral cancer, according to these findings.
Source:
Bastos, D. B., Sarafim-Costa, B. A. M., Santos-Sousa, A. L., Yokota, R., Biasoli, E. R., Casarini, D. E., Miyahara, G. I., & Bernabé, D. G. (2026). Higher plasma catecholamine concentrations in oral cancer patients and association with clinical and psychological characteristics. Psychoneuroendocrinology, 191, 107947. https://doi.org/10.1016/j.psyneuen.2026.107947
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