PSYCHOLOGICAL STRESS AND CANCER PROGRESSION
Abstract
Background: Psychological stress, particularly in its chronic form, is increasingly recognized as a factor influencing cancer progression through complex neuroendocrine, immunological, and molecular mechanisms. Chronic activation of the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system (SNS) leads to dysregulated cortisol and catecholamine levels, which suppress anti-tumour immunity, promote angiogenesis, and enhance tumour cell invasiveness and metastasis.
Aim: To synthesise current evidence on the biological mechanisms linking psychological stress to cancer progression and to highlight the therapeutic potential of psychosocial interventions in oncology.
Material and methods: A narrative literature review was conducted using the PubMed database. Relevant preclinical and clinical studies published between 2000 and 2024 were selected to examine the influence of psychological stress on cancer biology and disease progression.
Results: Chronic stress contributes to cancer growth, metastasis, and therapy resistance through hormonal imbalance, immune suppression, and chronic inflammation. Disruption of the tumour microenvironment further facilitates malignant progression. Studies particularly emphasize these effects in breast and ovarian cancers. Psychosocial interventions such as cognitive behavioural therapy (CBT) and mindfulness-based stress reduction (MBSR) have demonstrated benefits in both psychological well-being and biological markers of disease activity.
Conclusions: Psychological stress significantly impacts cancer progression through multiple biological pathways. Integrating stress-reducing interventions into standard oncological care may enhance patient outcomes and offer a complementary strategy in cancer management.
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Costanzo ES, Sood AK, Lutgendorf SK. Biobehavioral influences on cancer progression. Immunol Allergy Clin North Am. 2011 Feb;31(1):109-32. doi: 10.1016/j.iac.2010.09.001. PMID: 21094927; PMCID: PMC3011980.
Arrieta O, Angulo LP, Núñez-Valencia C, Dorantes-Gallareta Y, Macedo EO, Martínez-López D, Alvarado S, Corona-Cruz JF, Oñate-Ocaña LF. Association of depression and anxiety on quality of life, treatment adherence, and prognosis in patients with advanced non-small cell lung cancer. Ann Surg Oncol. 2013 Jun;20(6):1941-8. doi: 10.1245/s10434-012-2793-5. Epub 2012 Dec 22. PMID: 23263699.
DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med. 2000 Jul 24;160(14):2101-7. doi: 10.1001/archinte.160.14.2101. PMID: 10904452..
Carlson LE, Speca M, Faris P, Patel KD. One year pre-post intervention follow-up of psychological, immune, endocrine and blood pressure outcomes of mindfulness-based stress reduction (MBSR) in breast and prostate cancer outpatients. Brain Behav Immun. 2007 Nov;21(8):1038-49. doi: 10.1016/j.bbi.2007.04.002. Epub 2007 May 22. PMID: 17521871.
Andersen BL, Farrar WB, Golden-Kreutz DM, Glaser R, Emery CF, Crespin TR, Shapiro CL, Carson WE 3rd. Psychological, behavioral, and immune changes after a psychological intervention: a clinical trial. J Clin Oncol. 2004 Sep 1;22(17):3570-80. doi: 10.1200/JCO.2004.06.030. PMID: 15337807; PMCID: PMC2168591.
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