The stress psychological describes what a person feels when under mental, physical or emotional pressure. Although it is normal to experience psychological stress from time to time, people with high levels of psychological stress or who experience it repeatedly over a long period of time may have health problems (mental or physical).
Stress can be caused by everyday responsibilities and routine activities, as well as by less common situations, such as trauma or an illness of one’s own or a close family member. When people feel that they can not manage or control the changes caused by cancer or by the activities of normal life, they feel anguish. It has been increasingly recognized that anxiety is a factor that can reduce the quality of life of cancer patients. There is even some evidence indicating that extreme distress is associated with worse clinical outcomes. Clinical guidelines are available to help doctors and nurses assess degrees of distress and help patients manage them.
This fact sheet provides a general introduction to the stress that people may have when faced with cancer. More detailed information on specific psychological situations related to stress can be found in the sections on Related Resources and Selected Bibliography at the end of this fact sheet.
The body reacts to physical, mental or emotional pressure releasing hormones of stress(such as epinephrine and norepinephrine ) that increase blood pressure , accelerate the rate heart and raise levels of sugar ( glucose ) in the blood . These changes help the person act with greater force and speed to escape a perceived threat.
Research has shown that people who experience intense and prolonged (ie, chronic ) stress can have digestive , urinary , fertility problems and a weakened immune system . People who have chronic stress are also more susceptible to viral infections such as flu ( flu) or common cold and have headaches, sleep problems, depression and anxiety .
While stress can cause a series of physical health problems, the evidence that it can cause cancer is weak . Some studies have indicated a relationship between several psychological factors and an increased risk of cancer; however, this is not the case with other studies.
The apparent relationships between psychological stress and cancer could manifest in various ways. For example, people with stress can adopt certain habits, such as smoking, overeating or drinking alcohol , which increases a person’s risk of cancer. Or, someone with a family member with cancer may have a higher risk of cancer due to a shared hereditary risk factor , not because of the stress resulting from the family member’s diagnosis .
The physical, emotional and social effects of the disease can be stressful for people with cancer . Those who try to control stress by adopting risky behaviors, such as smoking or drinking alcohol , or those who become more sedentary may have a poorer quality of life after cancer treatment. On the contrary, it has been shown that people who use effective coping strategies to manage stress, such as relaxation and stress management techniques, have lower degrees of depression , anxiety and symptoms.related to cancer and its treatment. However, there is no evidence that successful control of psychological stress improves cancer survival .
Evidence from experimental studies does indicate that psychological stress can affect a tumor’s ability to grow and spread . For example, some studies have shown that when mice carrying human tumors were confined or isolated from other mice – situations that increase stress – their tumors were more likely to grow and spread ( metastasize ). In one set of experiments, tumors transplanted into mammary adipose tissues of mice had much higher rates of spread to the lungs and lymph nodesif the mice were chronically stressed that if they were not. Studies in cancer cells of mice and humans cultured in the laboratory have found that the stress hormone norepinephrine , which is part of the body’s combat or escape reaction system, can promote angiogenesis and metastasis.
In another study, women with triple-negative breast cancer who had been treated with neoadjuvant chemotherapy were asked about their use of beta-blockers, which are drugs that interfere with certain stress hormones, before and during chemotherapy. . Women who reported using beta-blockers had a better chance of surviving their cancer treatment without a relapse (return of cancer) than women who did not report the use of beta-blockers. However, there was no difference between the groups in terms of overall survival.
Although there is still no strong evidence that stress directly affects cancer outcomes, some data indicate that patients may experience a sense of helplessness or despair when stress becomes overwhelming. This response is associated with higher mortality rates , although the mechanism for this to occur is unclear. It may be that people who feel helpless or hopeless do not seek treatment when they get sick, give up early or do not follow potentially useful therapy , adopt risky behaviors such as drug use or do not keep up a healthy lifestyle, which results in an untimely death .
The social support and emotional can help patients learn to cope with stress psychological. This support can reduce the degrees of depression , anxiety and symptoms related to the disease and treatment in patients. Some methods may include the following:
More information on how cancer patients can overcome stress in PDQ ® summaries can be found in the list in the Related Resources section at the end of this fact sheet.
Some expert organizations recommend that all cancer patients be screened for anxiety at the start of treatment. Others also recommend retesting at critical points during the course of treatment. Health care providers can use a range of screening tools, such as a distress scale or questionnaire, to determine if cancer patients need help managing their emotions and other practical issues. Patients who show moderate or severe distress (or emotional distress) are usually referred to appropriate resources such as a clinical psychologist , social worker, chaplain or psychiatrist .