Depression, Cytokines and Pancreatic Cancer

Inclusion Criteria:

1. 40 years of age or older at the time of recruitment.
2. Unresectable/inoperable pancreatic adenocarcinoma (stage III or IV), receiving Gemcitabine or Gemcitabine-based combination therapy.
3. If in the "depressed" sample, patients with pancreatic cancer must meet DSM-IV criteria for a major depressive syndrome (based on the SCID) AND have an HDRS score of 18 or greater.
4. If in the "non-depressed" sample, patients with pancreatic cancer must not meet DSM-IV criteria for a major depressive syndrome (based on the SCID) AND must have a HDRS score of 17 or less.

Exclusion Criteria:

1\. A. Patient has reported experiencing or medical record indicates a serious medical event (i.e.,medical hospitalization (excluding hospitalization related to cancer diagnosis/treatment),myocardial infarction, stroke) within the year preceding study participation.

B. Patient has reported the presence of or medical record indicates:

* Type 1 Diabetes, unrelated to cancer diagnosis
* renal failure requiring dialysis
* inflammatory bowel disease 3. Patient has reported the presence of or medical record indicates an active secondary cancer diagnosis, however patients who have been treated for a past cancer and are 2 years disease free from that cancer can participate.

  4\. Presence of a medical/surgical condition obtained through self-report associated with elevated cytokine levels, such as:
* HIV/AIDS
* Auto-immune diseases such as SLE, Multiple Sclerosis, Rheumatoid Arthritis, Polymyalgia Rheumatica, Temporal Arteritis, Chronic Fatigue Syndrome, severe allergies
* Congestive Heart Failure
* Recent stroke
* Alzheimer's Disease
* Active infection;
* Acute pancreatitis
* Acute pericarditis
* Acute hepatitis including Hepatitis C
* Recent vaccination for viral disease
* Major surgery within the past 6 weeks

  5\. Patient Reports Receiving treatment (within two weeks) with:
* Interleukin
* Interferon
* Thalidomide
* NSAID's
* Cox-2 inhibitors
* Cancer vaccine therapies

  6\. Self-reported diagnosis with a major psychiatric disorder other than depression (e.g. psychosis secondary to Bipolar Disorder, Schizophrenia, Schizo-affective illness, substance abuse) so severe that, in the opinion of the study staff, would interfere with a patient's ability to give informed consent for research.

  7\. Cognitive impairment so severe that, in the opinion of the study staff, would interfere with a patient's ability to give informed consent or complete study measures for research.