Double role of depression in gastric cancer:As a causative factor and as consequence

In this editorial we comment on the article“Hotspots and frontiers of the rela-tionship between gastric cancer and depression:A bibliometric study”.Gastric cancer(GC)is a common malignancy in the digestive system with increased mortality and morbidity rates globally.Standard treatments,such as gastrectomy,negatively impact patients'quality of life and beyond the physical strain,GC patients face psychological challenges,including anxiety and depression.The prevalence of depression can be as high as 57%,among gastrointestinal cancer patients.Due to the advancements in treatment effectiveness and increased 5-year overall survival rates,attention has shifted to managing psychological effects.However,the significance of managing the depression doesn’t lie solely in the need for a better psychological status.Depression leads to chronic stress acti-vating the sympathetic nervous system and the hypothalamus-pituitary-adrenal axis,leading release of catecholamines inducing tumor proliferation,migration,and metastasis,contributing to GC progression.The dysregulation of neurotrans-mitters and the involvement of various signaling pathways underscore the complex interplay between depression and GC.Comprehensive strategies are required to address the psychological aspects of GC,including region-specific interventions and increased monitoring for depression.Understanding the intricate relationship between depression and GC progression is essential for developing effective therapeutic strategies and improving overall outcomes for patients facing this complex disease.In this Editorial we delve into double role of depression in the pathogenesis of GC and as a complication of it.

High Risk Factors of Pancreatic Carcinoma

Over the past decades, cancer has become one of the toughest challenges for health professionals. The epidemiologists are increasingly directing their research efforts on various malignant tumor worldwide. Of note, incidence of cancers is on the rise more quickly in developed countries. Indeed, great endeavors have to be made in the control of the life-threatening disease. As we know it, pancreatic cancer（PC） is a malignant disease with the worst prognosis. While little is known about the etiology of the PC and measures to prevent the condition, so far, a number of risk factors have been identified. Genetic factors, pre-malignant lesions, predisposing diseases and exogenous factors have been found to be linked to PC. Genetic susceptibility was observed in 10% of PC cases, including inherited PC syndromes and familial PC. However, in the remaining 90%, their PC might be caused by genetic factors in combination with environmental factors. Nonetheless, the exact mechanism of the two kinds of factors, endogenous and exogenous, working together to cause PC remains poorly understood. The fact that most pancreatic neoplasms are diagnosed at an incurable stage of the disease highlights the need to identify risk factors and to understand their contribution to carcinogenesis. This article reviews the high risk factors contributing to the development of PC, to provide information for clinicians and epidemiologists.

A review on the pathogenesis theory of cancerous toxin from the viewpoint of system theory

In recent years,traditional Chinese medicine(TCM)has made great progress in the prevention and treatment of cancer.It has gradually revealed its characteristics and advantages in clinical practice,including alleviating clinical symptoms,prolonging survival time,decreasing the adverse effects of chemotherapy,and improving living quality.However,clinical TCM treatment of cancer lacks systematic theoretical guidance,because ancient TCM has not formed a recognized theoretical system of cognitive cancer,and there still are different opinions on the pathogenesis of cancer.Due to the complexity of cancer,the essence of cancer pathogenesis has not been described accurately by using common pathogenic factors,such as pathogenic wind,cold,dampness,summer heat,dryness,and fire.Ancient and modern TCM physicians have a similar understanding that the occurrence of cancer is related to toxin.In the 1990s,the thought of cancerous toxin was first proposed by Prof Zhou Zhongying,a TCMmaster based onmore than 60 years of clinical practice,who used“pandemic Qi(Li-Qi)is a specific pathogenic factor of epidemic disease”in Wenyi Lun(Treatise on Pestilence)for references.The pathogenesis theory of cancerous toxin was gradually established under the guidance of the thought of cancerous toxin.It holds that the cancerous toxin,a special pathogenic factor of cancer,is the key pathogenesis of the occurrence of malignant tumors.According to the pathogenesis theory of cancerous toxin,the basic pathogenesis of malignant tumors is the accumulation of pathogenic factors and cancerous toxin,and the deficiency of the vital Qi(Zheng-Qi).Therefore,the treatment principle involves eliminating pathogenic factors,resolving cancerous toxin,and supporting the vital Qi.The anticancer detoxification methods and the classification of Chinese medicinal herbs with anticancer detoxification effects were put forward.System theory has much in common with the concepts in the theory system of TCM,such as the universal relation theory,asking for a concrete analysis of concrete conditions,the humanism thought,and so on.This article aims to describe,review,and analyze the pathogenesis theory of cancerous toxin based on system theory for clinical practices.