Cancer and Chronic Stress: Understanding and Addressing the Connection
Today I’m going to discuss some mechanisms by which chronic stress promotes cancer cell growth and outline some key actions you should take to lessen your stress load.
Let’s start with a quote by Tsonwin Hai, Ph.D, a professor of Molecular and Cellular Biochemistry at Ohio State University.
“If your body does not help cancer cells, they cannot spread as far. So really, the rest of the cells in the body help cancer cells to move, to set up shop at distant sites. And one of the unifying themes here is stress.”
This really gets at the essence of what this post is about - understanding this stress connection and utilizing methods to take advantage of it.
What Exactly is Stress?
To put it simply, stress is your body’s response to physical, mental, and/or emotional pressure. It causes chemical changes in your body that can raise your blood pressure, heart rate, and/or blood sugar levels.
It’s important that you know in which of the three stress categories you find yourself - acute, episodic acute, or chronic stress - as more stress hormones typically equate to more inflammation which typically results in more immune suppression as well as several other biochemical reactions which can impact cancer progression negatively.
In Which Stress Category Do You Fall?
Acute Stress
Acute stress you suffer for a short period of time that doesn’t impact tumor progression (i.e. a traffic jam, an argument, criticism at work). In a passing stress situation, the sympathetic nervous system triggers a fight or flight response including the hormones adrenaline and noradrenaline which communicate with target organs in your body such as your heart. Because it’s short term, acute stress doesn’t have enough time to do the extensive damage that is associated with long-term stress.
Episodic Acute Stress
Episodic acute stress is acute stress that is repeated with greater frequency. People in this category have a lot of “nervous” energy and/or worry a lot”. They “take on” too much or can’t avoid “taking on” too much because of their life circumstances. Individuals in this category often see nothing wrong with the way they conduct their lives as their stress is so habitual. This category is of more concern for those with a cancer diagnosis because of the frequency that their body is triggering stress hormones.
Chronic Stress
People in this category often don’t see a way out of their difficult situation. This is the stress of unrelenting demands and pressures for what seems like interminable periods of time. Chronic stress wreaks the most biochemical havoc. Some chronic stress stems from early childhood and/or experiences that become internalized and remain painful and present. A view of the world, or a belief system, is created that causes limiting thoughts (e.g., the world is a threatening place, people will find out I’M a pretender, I must be perfect all the time).
People are immediately aware of acute stress because it is new; they ignore chronic stress because it is old, familiar, and almost comfortable. You may notice yourself in more than one category, but separating out different types of stress in your life is critical to addressing them.
The Stress Mechanism
The reason I want to riff a bit on what is known about stress biochemistry when I can just say that stress has a growth-promoting influence on tumors and metastasis is to illustrate that there is a lot of science to back up why stress reduction and management is so important and shouldn’t be minimized as an “alternative” or “complementary” practice as compared to “real” cancer treatment. You can skip to the Action Steps if you find yourself yawning! Here goes:
The two main biological pathways involved in stress reactions are the sympathetic nervous system and the hypothalamic- pituitary–adrenal (HPA) axis.The sympathetic nervous system reacts to stress by releasing catecholamines, primarily norepinephrine and epinephrine, the so-called fight-or-flight hormones, from the adrenal gland and from sympathetic neurons. This is a good solution for acute stress.
In a chronic stress scenario, the hypothalamus releases the hormone CRH which stimulates the anterior pituitary gland to release the hormone ACTH. This releases the glucocorticoid cortisol produced by the adrenal cortex. Cortisol is thought to inhibit apoptosis, or programmed cell death, especially in lymphoma/leukemia. Cortisol, moreover, suppresses immune activity which then allows for cancerous cells to proliferate without correction and allows for more tumor vascularization.
Numerous studies have documented how chronic stress can accelerate cancer growth through the impact it has on gene activity (i.e., Ross, 2008. Journal of the National Cancer Institute; Tilan, et al 2010. Journal of Oncology; Smith, et al 2010. Future Oncology; Cui, 2019. Journal of Clinical Investigation; Dai, et al 2020. Frontiers in Oncology).
Cortisol also helps the body to deal with stressors by controlling how the body uses energy. So energy used for digestion or kidney function may be hijacked in the service of bringing more blood to the heart to outrun danger - a metabolic reaction that is good when you’re being chased by a lion but not good when the lion is a checking account that can’t be balanced. That’s because the body’s stress reaction doesn’t turn off! Studies suggest that prolonged activation of either system, brought about by chronic stress, is linked to promoting tumor growth.
Take Action Steps to Reduce Stress
Let me start by saying it’s never plain and simple how the body’s 20,000 + genes and their epigenetic expression do what they do! How someone is impacted by stress depends upon their level of stress, whether they have someone’s shoulder to cry on, one’s experiences over the years, one’s personality, and of course genetic and epigenetic factors. Our bodies also have endless tricks for healing.
As a caveat - I’m a big fan of mindfulness-based stress reduction. I have the MUSE headband which claims to measure your brainwaves. I just also purchased the N.O.W. Tone Therapy System which claims to transform you quickly into a deep meditative state. I love both! However, meditation nor a few minutes of mindfulness nor a good game of golf will do the trick if a person continues to have the same external stressors overloading his or her immune system.
You have to take a step toward throwing some of the heavy weight (read stress) that you consistently carry around overboard. Here are some actions you might consider to accomplish this:
1. Take a Stress Inventory
Broadly stated, there are external stressors and internal stressors. External stressors are essentially things that happen to you - relationships go south, finances come and go, you lose a job. Internal Stressors are essentially stress-inducing thoughts - you’re not good enough, I shouldn't have done that, and, in general, what meaning you assign to external stressors. Suffice to say, you can’t change everything that needs changing at once;
Do an Inventory of the Major External Stressors in Your Life
Start to Identify What Needs Changing
2. Make a Stress Reduction Plan
This is something we regularly do in our stress workshop at CCLM. We prioritize with a patient what needs tackling first, second, and third and map out the obstacles to doing so.
Choose One External Stressor That You Have a Chance of Modifying
Give Yourself a Reasonable Time Period in Which to Lessen It
3. Work on Changing Your Cognitions (Thought Patterns)
Keep in Mind that Small Changes Taken Together Create a Big Change
Tell a Friend Your Intention so you Have Some Partner/Accountability
Practice Kind Self-Talk
4. Reinforce Your New Behavior
Forgiveness Makes for a Second Chance to do Better the Next Time
Notice the Small Wins and Celebrate the Big Ones
Remember Progress Ebbs & Flows and it’s What You Do With the Ebb When it Comes
Rinse and Repeat
In Conclusion
Stress leaves its biological imprint on your body. In the right proportion, stress can be exhilarating. Too much of it can upend your physical health. The good news is that stress can be managed.
At CCLM we offer stress management workshops and experiential programs that are led by psychologists and other instructors who understand cancer firsthand and infuse cancer-related language and insights into their practice.
Contact us if you’re interested in any of our program offerings. We are currently registering for our intensive 4- and 8-week programs in February along with some stand alone classes. Book a Free 30 minute consultation to see if our programming is a right fit for you.
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