Stress management and cancer

DEFINITION: Stress management reduces and controls tensions rising from emotional and physical stress. Emotional stress can occur in response to situations that seem out of control or difficult to manage, such as a diagnosis or treatment for cancer. Physical stress, such as nausea, vomiting, and hair loss occurring as side effects of chemotherapy, can lead to emotional distress.

Physiology: The physiology of stress is often referred to as the “fight-or-flight response.” Faced with an immediate physical threat, the body gears up for physical confrontation or rapid retreat with the following physiological responses to stress:

• Neurotransmitters are released by the sympathetic nervous system
• Catecholamines and epinephrine surge, increasing body metabolism
• Heart and breathing rates increase
• Blood pressure rises
• Blood-clotting increases
• Digestive activities are suspended

Stress hormones: Catecholamines, epinephrine, and cortisol (the “stress hormones”) prepare the heart to beat harder and faster, cause the lungs to inhale more oxygen, and tense muscles in preparation for fight or flight. The blood levels of these hormones remain elevated for hours and have lingering effects on the body. Cortisol, a steroid hormone, stays at high levels for several hours and is particularly troublesome. One effect of this hormone is to reduce the immune response (which is why hydrocortisone creams can address the itchy symptoms of skin rashes and inflammations; hence, it is important not to use these creams on infections, which may become worse in the presence of cortisol). People who are chronically or often stressed are likely to have suppressed immune systems, resulting in more infections like colds or sinus infections.

Chronic stress: Problems arise when the stress response occurs in reaction to emotional problems, such as concerns over chronic illnesses, financial difficulties, criticism, traffic jams, or deadlines. Repetitive and prolonged stress leads to physical problems and stress-related diseases, including immune system dysfunction, digestive tract problems such as diarrhea or constipation, and cardiovascular difficulties, including palpitations (heart pounding) or irregular heartbeats. Sleep disturbances such as insomnia or lack of restful sleep can occur. Increased blood clotting contributes to heart attacks and strokes. Hence, stress feeds on itself, creating problems that, in turn, place more stress on human physiology.

One of the greatest stressors human beings face is that of a chronic illness, such as cancer. Not only does the diagnosis of cancer increase stress, but also the ongoing decisions, treatments, medical bills, insurance paperwork, and the simple coping with normal stresses of daily life escalate in the face of a cancer diagnosis and treatment. Stress from cancer-related issues can cause an increase in inflammation and anoikis inhibitions, allowing cancer cells to multiply and grow. Chronic stress can also cause neutrophils to activate proteins that awaken dormant cancer cells. The plethora of treatment options for different types of cancer has made it possible to live with many types of cancer for months or years. The ability of medical pharmacology and technology to increase the life span, while positive overall, also prolongs the period of time patients must cope with their disease, increasing stress. While studies have had varying results on whether chronic stress can cause cancer, evidence is clear that chronic stress can substantially worsen cancer in those already battling the disease, leading to faster disease progression. 

Stress reduction: Any chronic and repetitive stress must be recognized and met with stress reduction methods. Managing stress is as important for healthy people as it is for those facing cancer: Most people think of calming situations such as watching the sunset, curling up with an interesting book, or meditating. Although these relaxing situations may be good for some, others may need a thrilling situation, like a vigorous aerobic workout or a competitive game of tennis.

Sometimes, seeking balance is a good approach. A job that requires a great deal of thinking, decision-making, and problem-solving may be counterweighted by physical activity, such as walking to work or a basketball game after work. Those with physical jobs, on the other hand, may reduce their stress by engaging in more intellectual pursuits, such as playing cards or learning a foreign language. Managing stress improves not only the immune system but also one’s quality of life. It may well help protect against the physiological vulnerabilities that open the door to precancerous and cancerous conditions.

For those diagnosed with cancer, stress management is equally if not more important: Social support systems, like meeting with friends or associating with groups that have interests similar to one’s own, can help reduce stress and anxiety. Helpful support groups are usually available in most communities. Patients are also advised to seek advice from their healthcare provider, who is in the best position to offer it.

In one study, volunteers who wrote about “the most stressful event they had ever undergone” for twenty minutes on three consecutive days showed significant improvement compared with those who spent the same amount of time writing about neutral topics. Researchers theorize that writing may help patients make sense of what has happened to them and come to terms with its impact, thus reducing stress.

Making an effort to maintain a healthy diet can also reduce stress. Although some medical situations, such as postchemotherapy nausea and vomiting, may require vitamin supplementation and management with other medications, the best way to obtain necessary minerals and vitamins during most stressful episodes is via fresh fruits and vegetables. Minerals and vitamins in this natural state are more bioavailable, meaning they are more readily absorbed and utilized by the body than supplements in pill or powder forms.

Fortunately, several medications can relieve pain, alleviate nausea, and lessen anxiety. Music, deep breathing, caring for pets, and engaging in enjoyable activities with family and friends are well-known stress relievers. Many cancer patients report discovering a new appreciation for life and do not delay activities they find rewarding. Among the best stress relievers for cancer patients is the sense of well-being and purpose friends and family can bring by simply visiting and reminding patients of their value as friends and human beings. 

Bibliography

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Heid, Markham, and Lorenzo Cohen. “How Stress Affects Cancer Risk.” MD Anderson Cancer Center, www.mdanderson.org/publications/focused-on-health/how-stress-affects-cancer-risk.h21-1589046.html. Accessed 15 June 2024.

Sobel, David S., and Robert E. Ornstein. The Healthy Mind, Healthy Body Handbook. New York: Time Life Medical, 1996.

“Stress and Cancer.” National Cancer Institute, 21 Oct. 2022, www.cancer.gov/about-cancer/coping/feelings/stress-fact-sheet. Accessed 15 June 2024.

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