We will often see patients who, having completed their first battle with breast cancer and having been pronounced “cancer free,” will tell us that their greatest concern is recurrence. This concern of recurrence will of course present a lot of stress on the cancer survivor. Stress can and needs to be managed to help prevent disease progression. We are going to explore some research which demonstrates the importance of stress management in breast cancer survivors.
“Stress-associated neuroendocrine changes may contribute to disease course in post-surgical breast cancer patients and increase risk for breast cancer recurrence and mortality.”
Recently, doctors at the University of Miami published their research on the significance of stress management for breast cancer patients.(1)
- Stress among postsurgical breast cancer patients can affect biological processes that regulate the endocrine and immune systems and these influences can have long-term effects on disease outcomes.
- Chronically elevated cortisol (stress hormone) suppress the naturally occurring anti-inflammatories in the body (glucocorticoid receptors), as a result pro-inflammatory signals are released into the blood by small proteins – cytokines.
- Cytokines and their inflammatory messages can congregate near tumor cells.
- These cytokines may contribute to disease progression by promoting metastasis.
- Therefore stress-associated neuroendocrine changes may contribute to disease course in post-surgical breast cancer patients and increase risk for breast cancer recurrence and mortality.
“statistically significant results”
In March 2019, in the medical journal Supportive Cancer Care (2), researchers evaluated the effectiveness of mindfulness-based stress reduction in breast cancer patients. They did this by reviewing previously published research and making an accumulation of those findings. They looked at 14 research studies, documenting 1505 women with breast cancer.
These researchers found: “statistically significant results” for: physiological function, cognitive function,fatigue, emotional wellbeing, anxiety, depression, stress, distress. and mindfulness. Although the effects on pain, sleep quality, and global Quality of Life were in the expected (positive direction) direction, they were not statistically significant based on insufficient evidence. . . mindfulness-based stress reduction is worthy of being recommended to breast cancer patients as a complementary treatment or adjunctive therapy.”
The positive aspects of stress management in breast cancer patients
Earlier research from a combined Chinese and American team explored the positive aspects of stress management in breast cancer patients shedding another view on how stress management may prevent recurrence of breast cancer.
The researchers noted that after treatment completion, breast cancer survivors frequently experience residual symptoms of pain, fatigue, high levels of psychological stress, anxiety, depression, fear of recurrence, and metastasis.
“Post-treatment stress, in particular, can adversely affect health-related quality of life, which, in turn, induces onset or recurrence of chronic diseases. Effective interventions that target these psychological symptoms and their physiological consequences are needed”
One of the worst periods of stress, the researchers wrote, was when women completed main treatments (such as chemotherapy and radiotherapy) and they progress to and have to face the stage of “watchful waiting”, a stressful period when the physician seems to be “doing nothing”.
Therefore, survivors continue to report remaining physical symptoms of pain, fatigue, and sleep dysfunction, high levels of psychological stress, anxiety, depression, fear of recurrence and metastasis, and impaired quality of life. This the researchers report may even contribute to the recurrence or progression of the disease.
Women given the opportunity to learn stress management techniques during treatment may benefit well into survivorship.
In agreement with the research presented is a recent study shows that providing women with skills to manage stress early in their breast cancer treatment can improve their mood and quality of life many years later. Published online in CANCER, a peer-reviewed journal of the American Cancer Society, the findings suggest that women given the opportunity to learn stress management techniques during treatment may benefit well into survivorship.
In this study patients who learned relaxation techniques and new coping skills in a supportive group over 10 weeks experienced improved quality of life and less depressive symptoms during the first year of treatment.
In their latest report, the researchers found that the women who received the stress management intervention had persistently less depressive symptoms and better quality of life up to 15 years later.
November 20th Event
1 Amiel CR, Fisher HM, Carver CS, Antoni MH. The importance of stress management among postresection breast cancer patients. Future Oncol. 2016 Dec;12(24):2771-2774. Epub 2016 Oct 19.
2 Zhang Q, Zhao H, Zheng Y. Effectiveness of mindfulness-based stress reduction (MBSR) on symptom variables and health-related quality of life in breast cancer patients—a systematic review and meta-analysis. Supportive Care in Cancer. 2019 Mar 1;27(3):771-81.
3 Huang J, Shi L. The effectiveness of mindfulness-based stress reduction (MBSR) for survivors of breast cancer: study protocol for a randomized controlled trial. Trials. 2016;17:209. doi:10.1186/s13063-016-1335-z. 51316