Stress – A Risk Factor for Breast Cancer and Recurrence?
Stress is defined as a feeling of emotional or physical tension. It may be the result of any event or thought that makes you feel frustrated, nervous or angry. It is a biological response to demanding situations.
Major life events including day-to-day activities can contribute to stress. While some short-term stress may be a positive driving force, long-term chronic stress may take a toll on the body leading to poor sleep, unhealthy lifestyle and even certain conditions. It is thought that stress may affect the nervous, endocrine and immune system thereby weakening the body’s defences against infections.
An important question that comes up during the ongoing research is whether the effects of stress increase the risk of cancer and its recurrence.
Does Stress Cause Breast Cancer?
Some of us may have encountered someone who had noticed a lump which turned out to be cancer after a period of chronic stress or significant loss. But research has shown conflicting results.
A study in Poland comprising 858 women found out that young women who had endured traumatic life events had an increased risk of breast cancer. But at the same time, another study in the United Kingdom showed no consistent evidence regarding the relationship between stress due to adverse situations and breast cancer risk.
Association of negative emotions to breast cancer may seem natural but research has shown that it is not sure if the body is more vulnerable to breast cancer due to stress. It is therefore important to associate oneself to a support group or counsellor to help work through these emotions, both positive and negative.
Can Stress Cause Breast Cancer to Spread or Recur?
Even though it is not clear if stress directly causes breast cancer, it may have a role in people who already have or had the disease. When we are stressed, a hormone called ‘norepinephrine’ is released. This stimulates the formation of new blood vessels (angiogenesis) that helps tumor cell growth and fastens the spread of cancer (metastasis). Another hypothesis involves the telomerase activity, which also gives a biological basis to the claim that stress may facilitate recurrence or spread of cancer.
Studies in mice showed that there was a relationship between a stressful environment and cancer spread. In humans also, stress has shown to play a role in increasing cancer spread although it is difficult to ignore the other factors. In a larger study, women with some types of breast cancer lived longer if they participated in mindfulness stress reduction activities.
Some indirect ways wherein stress can cause breast cancer may be alcohol abuse and insomnia.
So, it does appear that stress can be bad for patients who have had cancer. By involving oneself in stress-free and mind relaxing activities, cancer growth and spread can be delayed or even avoided.
Stress and Survival:
A trial has shown that people involved in a ten-week stress management intervention had significantly lower mortality rates thus proving that reducing stress improves survival. Sometimes due to stress, patients may miss appointments and follow-ups which indirectly affects survival. If at any point in the cancer journey, the patient is feeling so stressed that he keeps missing appointments, it is better to consult a social worker or a therapist for help.
Coping with Cancer:
Coping with cancer and its side effects is an important part of the cancer journey. Some of the techniques which help in the process include acupuncture, cognitive behavioural therapy, helping others, journaling, massages, meditation, support groups, walking, yoga and many more.
Cancer diagnosis itself is stressful but the direct corelation between stress and the risk of breast cancer and its recurrence is not conclusive. Certain outcomes of stress like insomnia, smoking, alcohol abuse, obesity, missing doctor appointments and an unhealthy lifestyle may indirectly increase the risk of cancer and its spread. Finding the stress triggers and learning to cope with them can improve the quality of life in cancer patients.
Dr. A. Preethi
Medical Oncologist
Kauvery Hospital, Chennai