Minding the body: Psychotherapy and cancer survival

Abstract

What is known? Stress and support have been thought to be related to cancer risk and progression, but evidence has been mixed. Depression is a natural co-morbid condition with cancer. It has not been clear how stress and support could physiologically affect the rate of cancer progression. Immune function was not thought to have much relevance to cancer progression. Few other physiological mechanisms linking stress to cancer progression were known. What does this paper add? There is evidence from 15 RCTs indicating that effective psychosocial support improves quantity as well as quality of life with cancer. There is evidence that chronic depression predicts poorer prognosis with cancer. Dysregulated circadian cortisol patterns predict more rapid cancer progression. Inflammatory processes affect cancer growth and progression. Sympathetic nervous system activity, telomere length, telomerase activity, and oncogene expression are affected by stress and can affect cancer growth.

Exposure to road traffic and railway noise and postmenopausal breast cancer: A cohort study

“…Also, we find that shorter term exposure to road traffic noise (1 year) seems slightly stronger associated with breast cancer than longer term exposure (10 years). A possible explanation might be that noise‐induced stress affects progression of breast tumors and not tumor initiation, which corresponds to overall findings from epidemiological studies on psychosocial stress and breast cancer …”

“…Glucocorticoids are involved in a variety of cellular and physical processes that might promote tumor progression including apoptosis, immune response and angiogenesis . Though psychosocial stress has been suspected of affecting breast cancer risk and progression for many years, epidemiological studies have failed to find any clear relationship with risk for breast cancer, whereas a number of studies have indicated that psychosocial stress and support may affect the course of breast cancer progression …”

A bio-psychosocial intervention program for improving quality of life in breast cancer survivors: Results of a prospective randomized trial

“…[22] The majority of such studies have focused on breast cancer survivors; many have attempted to define the mechanisms involved in improving survival with psychosocial intervention including the hypothalamic-pituitary axis, the immune system, disruption of other circadian rhythms such as sleep/activity, the sympathetic-adrenal-medullary system, and the relationship between stress and p53 gene expression. [23] However, there is significant controversy around whether or not BPSI improves survival. [24] This has resulted from factors including lack of consistency in definition of intervention, [25] and inadequate sample sizes.…”

Review of psychotherapeutic interventions on depression in cancer patients and their impact on disease progression

“…Various clinical and epidemiological studies have demonstrated that tumour growth, progression, and metastasis are associated with reported patient stress, depression, and anxiety, as well as with limited perceived social support and poor coping mechanisms (Lillberg et al, 2003;Spiegel, 2002;Spiegel & Giese-Davis, 2003). Pathways linking stress reduction to changes in endocrine, immune and autonomic nervous system function and pathways linking gene expression to cancer progression are being studied (Rutter et al, 2008;Spiegel, 2013).…”