Does Stress Cause Cancer?
- New research is suggesting that the body’s physiological and psychological response to challenges can negatively impact tumor immunity among women with breast cancer. Tumor immunity is the body’s immune system’s ability to acknowledge and fight cancer cells, potentially preventing their growth and spread.
- A study published in JAMA Network Open, suggest that chronic inflammation and immune dysfunction caused by stress “may be associated with increased breast cancer aggressiveness and cancer disparities in socially vulnerable and minoritized populations.”
- Researchers have been looking to answer whether stress causes cancer for years. However, according to the U.S. National Institutes of Health (NIH)’s National Cancer Institute (NCI), “the evidence that stress causes cancer is weak.”
- Most studies to date have highlighted a link between stress and cancer, not a cause. This means that the evidence does not show that the cancer diagnoses in people with chronic stress are because of the stress. They could, instead, stem from some other variable, like genetic inheritance or known cancer-causing behaviors that tend to go hand in hand with stress.
- “It may be that stress leads people towards unhealthy behaviors that are more directly associated with cancer,” Dr. Allyson Ocean, Associate Professor of Clinical Medicine at Weill Cornell Medical College/ New York Presbyterian Hospital, told SurvivorNet in an earlier interview.
According to a new study, titled “Multilevel Stressors and Systemic and Tumor Immunity in Black and White Women With Breast Cancer,” and published on February 14 in JAMA Network Open, chronic inflammation and immune dysfunction caused by stress “may be associated with increased breast cancer aggressiveness and cancer disparities in socially vulnerable and minoritized populations.”
Read MoreThe study authors state how they “identified novel, distinct molecular features associated with each stress-related factor, as well as common pathways shared across them.”
“Systemically, stress was associated with circulating proteins known to promote immune and cancer cell chemotaxis, angiogenesis, and inflammation, most robustly in Black women. The positive association between stress and suppression of anti-tumor immunity was most apparent in Black women,” the authors explained.
These findings ultimately illustrate the complex relationship social factors and changes in the immune system that may play a role in cancer progression.
Dr F. Perry Wilson, of the Yale School of Medicine, offered some commentary on this new study, which measured women’s stress levels across their daily activities, social isolation, racial discrimination, and neighborhood depravation. And all of these stress sources were connected to harmful changes in the body’s immune function, including around the tumor and the biology of the tumor.
Writing for Medscape’s’ Impact Factor, Wilson said, “I’ll start with the immune system overall. The response to stress here is a bit complicated. In some ways, stress increases activity in the immune system — which would seem like a good thing.
“The immune system doesn’t only fight off bacteria and viruses, it also identifies cells that are misbehaving in your body and kills them before they can kill you.”
He continued, “But the way stress revs up the immune system is not helpful in preventing cancer. More stress leads to higher levels of things like angiopoietins, which are substances that promote the growth of blood vessels into tissues.
“Targeting angiopoietins is a mainstay of cancer therapy, because tumors need blood vessels to sustain their growth, so the fact that stress increases their production is very much a bad thing.”
Find a way to chill. That’s my challenge to you this week. It’s not a very chill time.
If you want more on this study, I wrote about @medscape this week: https://t.co/kka2R7RXY4
(end of thread)— F. Perry Wilson, MD MSCE (@fperrywilson) February 20, 2025
He also said, “It’s worth noting that these effects were generally more pronounced in Black compared with white women, which may provide some explanation on why breast cancer incidence and severity are higher in that population.
“I should also note that although racial discrimination, social isolation, and neighborhood deprivation all had significant relationships with some pro-cancer markers, simple prolonged daily stress had the most consistent relationship across all the domains. Which makes sense, honestly.”
“After all, things like racial discrimination, social isolation, and neighborhood deprivation increase stress levels, that’s probably part of the reason they have such adverse outcomes on health,” Dr. Wilson added.
Understanding Stress & Breast Cancer
Patients often wonder if a stressful event in their life led to their breast cancer diagnosis. This is a question oncologists are asked every day. While stress is not good for any of us and it does impact our immune systems, there is no proof that stress is a cause of breast cancer.
Expert Resources On Coping With Emotions & Stress
- Best Ways to Deal With Stress — Advice from SurvivorNet Community Members
- Can Stress Reduction Actually Reduce Cancer Risk For High Risk Women? Some Fascinating Study Results
- No, Stress Doesn’t Cause Cancer. But it Can Lead to Other Cancer-causing Habits and Conditions
- Responding to Stress: How to Cope With Complex & Changing Emotions
- Mental Health and Cancer — The Fight, Flight or Freeze Response
- Fear, Anger, Anxiety: You’re Entitled To Your Emotions
There are plenty of people that lead very healthy lives, have great diets, remove themselves from the stress and pollution of big cities, meditate every day, and still get diagnosed with breast cancer.
Though stress can certainly contribute to how patients deal with their diagnosis, there is no evidence supporting the idea that it could actually cause the diagnosis.
This doesn’t mean that stress isn’t something to be kept in mind while dealing with a diagnosis or treatment. Patients and their families should consider stress management a very important part of leading a healthy lifestyle even if the stress itself was not a factor in their cancer diagnosis.
RELATED: Did My Hectic Lifestyle Cause My Cancer?
If a patient is very stressed out and very anxious, Dr. Elizabeth Comen recommends seeking help to manage that stress because it could affect treatment moving forward.
Does Stress Cause Cancer?
Researchers have been looking to answer whether stress causes cancer for years. However, according to the U.S. National Institutes of Health (NIH)’s National Cancer Institute (NCI), “the evidence that stress causes cancer is weak.”
Most studies to date have highlighted a link between stress and cancer, not a cause. This means that the evidence does not show that the cancer diagnoses in people with chronic stress are because of the stress. They could, instead, stem from some other variable, like genetic inheritance or known cancer-causing behaviors that tend to go hand in hand with stress.
“It may be that stress leads people towards unhealthy behaviors that are more directly associated with cancer,” Dr. Allyson Ocean, Associate Professor of Clinical Medicine at Weill Cornell Medical College/ New York Presbyterian Hospital, told SurvivorNet in an earlier interview.
Smoking, unhealthy eating, and drinking too much alcohol are just several examples of stress-related behaviors that have known associations with cancer.
When someone experiences stress, be it emotional, physical, or mental, the body responds by releasing the stress hormones epinephrine (adrenaline) and norepinephrine (noradrenaline). These hormones increase blood pressure, heart rate, and blood sugar levels, all of which are vital for the human “fight or flight” response. They make it possible to escape danger and perform physical feats in times of duress.
However, when these hormones are released constantly over an extended period of time, rapid heart rate and heightened blood pressure can become a problem. Risk factors for heart conditions, weight gain, and diabetes may rise.
“With regard to cancer, there is little convincing evidence that chronic stress causes cancer initiation,” Dr. Lorenzo Cohen, Professor and Director of the Integrative Medicine Program at MD Anderson Cancer Center, told SurvivorNet, “[But] there is extensive evidence that chronic stress can promote cancer growth and progression.” This, he said, is due to the fact that the constant release of epinephrine and norepinephrine “leads to diverse biological effects of key cancer pathways, including the stimulation of cancer invasion, suppressed immune function, and even reduced efficacy of chemotherapeutic agents.”
How To Turn Stress Into Strength
The suppressed immune function that Dr. Cohen mentioned may make it difficult for your body to attack cancer cells on its own.
“We know that there have been several studies that have looked at healing and recovery after cancer surgery or have looked at recurrence,” Dr. Heather Yeo, Associate Professor of Surgery and Healthcare Policy and Research at Weill Cornell Medical College, assistant attending surgeon at NewYork-Presbyterian/Weill Cornell Medical Center, and medical advisor to SurvivorNet previously explained.
“And we know that when your immune system is down, there’s an excess of stress hormones going on. Your body has a hard time recovering, and cancer takes advantage of that.”
No, stress does not cause cancer.
However, stress can cause various chain reactions of unhealthy phenomena, in turn creating a more hospitable environment for cancer to develop and spread.
That’s why it’s so important whether you’ve been diagnosed with cancer already or are looking to prevent a future diagnosis to take care of your body and mind.
Physical activity can work wonders. “Exercise, which is recommended to reduce stress levels, has been associated with a decrease in recurrence rates for certain cancers like colorectal cancer and breast cancer,” Dr. Ocean told us. Other ways to mitigate stress include getting enough sleep, eating healthily, and practicing mindfulness.
Meditation has also been proven to decrease psychological stress in those who are dealing with cancer. Survivor Shannon Masur, who previously spoke to SurvivorNet about her colon cancer and Lynch Syndrome, told us she knew very little about meditation at first but that it ultimately helped her to let go of her fears.
“I had never meditated before,” Shannon said.
“I thought it would be such a challenge, but it really wasn’t, and just having that sense of calmness that comes into me when I’m meditating has been really, really helpful for me.”
How to Cope With Complex & Changing Emotions
When a stressful life event occurs, people may react with a range of different (and quickly changing) emotions. This is completely normal.
“The way people respond is very variable,” Psychiatrist Dr. Lori Plutchik previously toldSurvivorNet. “Very much consistent with how they respond to stresses and challenges in their life in general.”
Responding to Stress: Psychiatrist Dr. Lori Plutchik’s Advice
Dr. Plutchik explained that people can react after a cancer diagnosis with a huge range of emotions from fear to anger to determination. However, the conclusion remains the same no matter what stressor someone may be dealing with: your emotions are valid and seeking mental health help may look different for every person.
“People have a range of emotions when they’re diagnosed with cancer,” Dr. Plutchik said. “And they can include fear, anger … and these emotions tend to be fluid. They can recede and return based on where someone is in the process. Going through a cancer diagnosis is just the beginning of a complicated, complicated process.”
Dr. Plutchik added that the patient, or person going through the stressful event, should accept that emotions will be fluid. You may feel fine one day and then feel a massive wave of stress the next. It’s also important for those you look to for support whether that’s a therapist, friends and family, or both to understand the fluidity of stress-related emotions.
If a stressful event is affecting how you think and feel, it may be time to seek some sort of mental health treatment. This could mean traditional talk therapy, medication, changing lifestyle habits (like exercise and diet), seeking out a support group, or many other approaches.
Managing Your Mental Health
A diagnosis of cancer or disease or some external stressor like a troubled relationship, or even racial discrimination, can offset your mental health in ways you least expect.
Psychiatrist Dr. Lori Plutchik says your emotions will be fluid when facing a diagnosis. SurvivorNet has some tips to help keep your mental and emotional health in a good space if you find yourself coping with a stressful situation.
The National Institute of Mental Health says you should seek professional help if you are experiencing severe or distressing symptoms that have lasted two weeks or more, such as:
- Trouble sleeping
- Changes in appetite
- Struggling to leave bed in the morning because of your mood
- Trouble concentrating
- Loss of interest in things you usually enjoy
- Inability to perform normal daily functions and responsibilities
Equally as important is recognizing the value of self-care. The National Institute of Mental Health offers practical guidance on how to boost your weekly self-care routine.
- Regularly exercising
- Eating healthy, regular meals
- Staying hydrated
- Prioritizing sleep
- Exploring relaxation programs or techniques
- Setting goals/priorities
- Staying positive
- Connecting with others
Genetic testing can also help people wrestling with their mental health. It has been shown to match people with the best medication for mental health treatment. While genetic testing has helped make treatment plans for other diseases, such as certain types of cancer, the ability to use it to help people suffering from anxiety and depression is relatively new.
“Doing the genetic testing has absolutely transformed the landscape of psycho-pharmacology,” psychiatrist Dr. Plutchik tells SurvivorNet.
“It’s something that I highly recommend for anybody that is taking medication, whether they are being treated for cancer or not … I recommend it for children who are taking medication. I recommend it for elderly people. Anybody who is taking medication, I think, can greatly benefit from genetic testing.”
Contributing: SurvivorNet Staff
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