Chronic Stress and Susceptibility to Skin Cancer

Saul, Alison N.; Oberyszyn, Tatiana M.; Daugherty, Christine; Kusewitt, Donna F.; Jones, Spencer S.; Jewell, Scott D.; Malarkey, William B.; Lehman, Amy; Lemeshow, Stanley; Dhabhar, Firdaus S.

doi:10.1093/jnci/dji401

Cited by 181 publications

(176 citation statements)

References 49 publications

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“…Perhaps most contentious is the apparent association between stressful events and skin cancer. Interestingly, chronic stress has been shown to increase susceptibility to UV-induced SCC in mice, 47 and more than 50% of a group of 75 patients with CMM reported at least one episode of major stress in the 5 years prior to diagnosis. 48 A potential mechanism is that chronic stress negatively affects many physiological processes through prolonged exposure to elevated levels of glucocorticoids and catecholamines 19 or as negative effects on natural killer cell and T-cell function relevant for tumour immunity.…”

Section: Discussionmentioning

confidence: 99%

“…23 In mice, chronic stress has been shown independently to suppress immunity and may contribute to skin cancer risk or enhance tumour growth. 47,49,50 Stress can also affect the cellular process involved in the repair of damaged DNA 51,52 and could thereby facilitate the establishment of oncogenic UV-induced mutations as an additional mechanism. Although it is difficult to refute the potential for recall bias in this study, there is growing evidence that stressful experiences may be a very real risk factor for cancer in general and, in this case, for all three types of skin cancer.…”

Section: Discussionmentioning

confidence: 99%

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Known and potential new risk factors for skin cancer in European populations: a multicentre case-control study

Vries

Trakatelli

Kalabalikis

et al. 2012

British Journal of Dermatology

140

111

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BACKGROUND: \ud \ud During recent years numerous studies have suggested that personal and environmental factors might influence cancer development.\ud \ud OBJECTIVES: \ud \ud To investigate environmental and personal characteristics associated with skin cancer risk.\ud \ud METHODS: \ud \ud A multicentre hospital-based case-control study was performed in Finland, Germany, Greece, Italy, Malta, Poland, Scotland and Spain, including 409 patients with squamous cell carcinoma (SCC), 602 with basal cell carcinoma (BCC) and 360 with cutaneous malignant melanoma (CMM) and 1550 control persons. Exposures were assessed by questionnaires that were partly self-administered, partly completed by dermatologists. Unconditional logistic regression modelling was used to assess associations including the influence of certain drugs and food items on skin cancer risk.\ud \ud RESULTS: \ud \ud The usual associations were observed for sun exposure and pigmentation characteristics, with chronic sun exposure being most strongly associated with SCC risk, and naevi and atypical naevi with CMM risk. Use of ciprofloxacin was associated with a decreased risk of BCC [odds ratio (OR) 0·33] and use of thiazide diuretics was associated with an increased risk of SCC (OR 1·66). Ciprofloxacin was also associated with SCC (OR 0·34) and thiazines with BCC (OR 2·04), but these associations lost significance after correction for multiple testing. Consumption of pomegranate, rich in antioxidants, was associated with decreased BCC and SCC risk, also after correcting for multiple testing. Recent experience of stressful events was associated with increased risk, particularly of CMM.\ud \ud CONCLUSIONS: \ud \ud In this large case-control study from across Europe the expected associations were observed for known risk factors. Some new potential protective factors and potential risk factors were identified for consumption of certain food items, medication use and stress, which deserve further investigation in future studies

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Known and potential new risk factors for skin cancer in European populations: a multicentre case-control study

Vries

Trakatelli

Kalabalikis

et al. 2012

British Journal of Dermatology

140

111

View full text Add to dashboard Cite

show abstract

“…The concept of "cancer proneness," "cancerous personality" or "personality susceptible to immunosuppression" assumes the tendency to repress emotional reactions to difficult life events (Dattore et al, 1980;Eysenc, 1985;Watson, Pettingale, & Greer, 1984). The researchers explain greater incidence of cancer among repressors by the impaired reaction of immune defense and by the hormonal changes as a result of long maintenance of stress due to inhibited expression of dissatisfaction and, in parallel, ineffective coping with stressors (KiecoltGraser, & Glaser, 1986;Penedo et al, 2006;Reiche, Nunes, & Morimoto, 2004;Saul et al, 2005;Septon, & Spiegel, 2003;Zorrilla, Luborsky, & McKay, 2011).…”

Section: Introductionmentioning

confidence: 99%

Suppression of negative affect in cancer patients. Trauma and defensiveness of self-esteem as predictors of depression and anxiety

Fila-Jankowska¹,

Szawińska²

2016

Polish Psychological Bulletin

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“…26, 41 Saul et al 42 demonstrated in animal experiments that chronic stress caused the suppression of type I cytokines, reduction of T-helper cell counts and increased T-suppressor cell numbers together with enhanced susceptibility to UV-induced squamous cell carcinoma. Repeated exposure to stress can thus lead to an increase in regulatory T cells in UV-induced skin cancer and may thus be among the reasons for the observed increase in T-regulatory function in melanoma patients.…”

Section: Neuroendocrine-immune Interaction and Skin Cancer Control: Tmentioning

confidence: 99%

Psychological support of skin cancer patients

Peters

2012

British Journal of Dermatology

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SummaryThe diagnosis of skin cancer imposes a great stress on our patients. Ultraviolet (UV) radiation-induced skin cancers are on the rise and frequently occur in younger patients and unexposed sites despite improved protective behaviour. Environmental factors and lifestyle habits have changed greatly in the last century and in addition to UV radiation exposure, psychosocial stressors and physical inactivity may play a role in the rising tumour incidence. With environmental stressors such as UV radiation they share the capacity to change the stress reaction. So far research into the interaction between stress, cancer and psychosocial intervention has generated some interesting results with respect to improvement of quality of life and the function of the hypothalamic-pituitary-adrenal axis, the sympathetic axis and natural killer cells. These results hint at a suppressive effect of chronic stress on cellular immunity and the importance of a sufficient length and intensity of any psychosocial intervention for it to be effective. Nevertheless, the evidence remains inconclusive and does not take into account the findings of current psychoneuroimmunological research. This research has demonstrated the importance of a third stress axis along which neurotrophins and neuropeptides are effective. Along this axis, regulatory mechanisms may contribute to suppress tumoricidal immune responses. This may be instrumental in the establishment of an immune response that promotes tumour progression and holds important implications for integrated therapeutic strategies. However, research into the psychoneuroimmunological benefits of psychosocial intervention is largely missing, and future interdisciplinary research is warranted for understanding and further promoting improved quality of life and psychological as well as physical well-being after psychosocial intervention.Recent studies point to the steadily rising incidence of skin cancers and the pressure rises to identify explanatory models in addition to ultraviolet (UV) radiation exposure and other environmental stressors. Among them, psychosocial stress may play a hitherto underestimated role as several studies suggest that the immune response can be modified by stress and plays a role in the association between coping with a cancer diagnosis, i.e. mental stress, and long-term survival.

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Chronic Stress and Susceptibility to Skin Cancer

Abstract: Chronic stress increased susceptibility to UV-induced squamous cell carcinoma in this mouse model by suppressing type 1 cytokines and protective T cells and increasing regulatory/suppressor T cell numbers.

Cited by 181 publications

References 49 publications

Known and potential new risk factors for skin cancer in European populations: a multicentre case-control study

Known and potential new risk factors for skin cancer in European populations: a multicentre case-control study

Suppression of negative affect in cancer patients. Trauma and defensiveness of self-esteem as predictors of depression and anxiety

Psychological support of skin cancer patients

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