In this article we will discuss the role of inflammation in spreading or recurring breast cancer and possible treatments.
Inflammation helps makes cancer
The role and more so, the control of inflammation is so significant in breast cancer survival that scientists continuously publish papers on identifying and mapping genes that “express” inflammatory factors that impact breast cancer patients. A recent study in the journal cancer medicine (1) demonstrates the point. Here researchers found three inflammation-related genes that could predict risk in prognosis and metastasis of patients with breast cancer. These genes are able to predict recurrence or metastasis because they are pouring out messages to other cells to increase the inflammatory response. Inflammation helps makes cancer.
What is the role of stress management in stopping this inflammation?
A February 2021 study produced by the University of Miami Miller School of Medicine (2) wrote that “A randomized controlled trial of 5-week stress management interventions teaching cognitive behavioral therapy (CBT) or relaxation training (RT) techniques showed decreases in stress and serum inflammatory markers over 12 months in women undergoing treatment for breast cancer. . .These effects are likely brought about by improved stress management skills.”
Another recent study in the journal Cancer (3) examined the role of stress management in breast cancer. In this paper, researchers noted that women with breast cancer experience heightened distress, which is related to greater stress induced inflammation and poorer outcomes.This research comes from the University of Miami.
The study focuses on the s100 protein family and its genes which facilitates the inflammatory response in the body. The s100 family has been associated with accelerated tumor development and metastasis.
A previous study from these researchers examined a 10-week stress-management intervention using cognitive behavioral therapy and relaxation training and found less leukocyte (white blood cell) inflammatory gene expression in patients with breast cancer. The authors noted that because a 10-week intervention may be impractical during primary treatment for breast cancer, the authors developed a program of cognitive behavioral therapy and relaxation training and demonstrated its efficacy in reducing distress over 12 months of primary treatment with the focus on the s100 protein family’s type of inflammation.
Participants (average age about 55) were assigned to either cognitive behavioral therapy or relaxation training had significant s100 protein family decreases over 12 months compared with those who were assigned to the control group.
In the end – less inflammation, less cancer.
Mindfulness Therapies are stress management techniques focused on medication and a retraining of cognitive behavioral skills which can including coping skills.
A November 2018 study published in the journal Einstein, (4) suggests that Mindfulness-Based Stress Reduction can be considered a promising alternative for the treatment of breast cancer symptoms. The results show that Mindfulness-Based Stress Reduction, alone or integrated with other cognitive interventions (nutrition education intervention, Metacognition group therapy), is effective for main symptoms of breast cancer. The researchers concluded: “These findings demonstrate the need for greater provision of alternative treatments for breast cancer symptoms. ”
Earlier research (5) on Mindfulness-Based Stress Reduction 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.
Mindfulness and fatigue in breast cancer patients
A February 2020 study (6) examined whether the fatigue breast cancer patients suffer from could by modified by Mindfulness techniques. Let’s remember that this article is about ionflammation and that stress management techniques help reduce this inflammation. Inflammation, among other factors, is a component of fatigue cause in breast cancer patients.
Results of this paper: “This study investigated the mediating effects and relevance of mindfulness, anxiety, depression, pain, loneliness, and sleep disturbance in the context of the relation between mindfulness and the fatigue of breast cancer survivors. We found that mindfulness, while having a direct effect on fatigue, also induced fatigue indirectly via anxiety, depression, pain, sense of isolation, and sleep dysfunction. This suggests that mindfulness-based interventions affect multiple related factors and may constitute effective care that can alleviate fatigue. The results of this study reveal interrelations among factors related to mindfulness and fatigue, yielding new knowledge that will be useful in achieving effective care for relieving fatigue.”
Stress hormones and inflammation
Recently, doctors at the University of Miami published their research in the journal Future oncology (7) on the absolute significance of stress management for breast cancer patients.
Stress among post-surgical 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 or breast cancer recurrence and mortality.
You need good life partners to help with the challenges of breast cancer
A study from researchers at the Dana-Farber Cancer Institute, Harvard Medical School, and the Mayo Clinic published in the journal Psycho oncology (8) found that having good partner support may play a key role in a young woman’s adjustment to a serious stressor such as breast cancer.
In this study Six hundred seventy-five young women with breast cancer Stages I-III, median age 36, completed a self-report baseline questionnaire on the perceived support they get from their spouse/partner.
Women in an unsupported-partnered relationship had higher odds of anxiety symptoms compared with women in a supported-partnered relationship. Young age and being financially insecure were also both independently associated with anxiety in breast cancer patients.
Because supportive efforts of a partner have potential to protect against the impact of stress, interventions to enhance partner support and reduce anxiety might be beneficial to address challenges experienced as a couple in this setting.
In May 2020, researchers at The Ohio State University College of Medicine wrote that “Relationship Satisfaction Predicts Lower Stress and Inflammation in Breast Cancer Survivors.” Here is what they published in the journal Psychoneuroendocrinology.(9)
“Breast cancer survivors with elevated inflammation have a greater risk for cancer recurrence, premature mortality, and comorbid disease development. The psychological stress survivors experience when confronted with a breast cancer diagnosis and cancer treatment can heighten inflammation.
Breast cancer survivors in satisfying romantic relationships felt less stressed and in turn had lower inflammation throughout cancer treatment. This study illustrates the utility of a within-person approach to not only consider the average effects of relationship satisfaction, but also how changes in their own relationship satisfaction impact stress and inflammation over time. Our findings demonstrate important psychological and immunological pathways through which satisfying relationships may promote breast cancer survivors’ long-term health.”
Our cancer program
At the Magaziner Center for Wellness, our treatments are focused on reducing inflammation, enhancing the cellular immune response, and inactivating cancer stem cells since these are the cells that cause cancer recurrences and are much more harmful than the actual tumor cells—all with the goal of improving quality of life, strength and vigor, and extending life span. We place particular emphasis on an anti-inflammatory diet and lifestyle, and biologic agents that quiet the inflammatory pathways since inflammation has been found to foster the growth of cancer cells.
Most of our patients have already been through the rigors of conventional treatments but either experienced untoward side effects or unsatisfactory outcomes as the cancer continued to grow. The sooner we begin treatment, the better, since there is usually less damage to the immune system and to the vital organs. Your body then has a better chance to recover.
Our program emphasizes the concept of Thriving While Surviving. We strive to transform cancer from an acute disease into more of a chronic illness, one that can be lived with for many months or even years.
If you would like to explore more information, please contact our office so we can start a conversation with you.
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References
1 Zhao S, Shen W, Du R, Luo X, Yu J, Zhou W, Dong X, Gao R, Wang C, Yang H, Wang S. Three inflammation-related genes could predict risk in prognosis and metastasis of patients with breast cancer. Cancer Med. 2019 Jan 11. doi: 10.1002/cam4.1962.
2 Diaz A, Taub CJ, Lippman ME, Antoni MH, Blomberg BB. Effects of Brief Stress Management Interventions on Distress and Leukocyte Nuclear Factor Kappa B Expression During Primary Treatment for Breast Cancer: a Randomized Trial. Psychoneuroendocrinology. 2021 Feb 4:105163.
3 Taub CJ, Lippman ME, Hudson BI, Blomberg BB, Diaz A, Fisher HM, Nahin ER, Lechner SC, Kwak T, Hwang GH, Antoni MH. The effects of a randomized trial of brief forms of stress management on RAGE-associated S100A8/A9 in patients with breast cancer undergoing primary treatment. Cancer. 2019 Jan 11. doi: 10.1002/cncr.31965. [Epub ahead of print] PubMed PMID: 30633331.
4 Castanhel FD, Liberali R. Mindfulness-Based Stress Reduction on breast cancer symptoms: systematic review and meta-analysis. Einstein (Sao Paulo). 2018;16(4):eRW4383. Published 2018 Nov 26. doi:10.31744/einstein_journal/2018RW4383
5 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
6 Ikeuchi K, Ishiguro H, Nakamura Y, Izawa T, Shinkura N, Nin K. The relation between mindfulness and the fatigue of women with breast cancer: path analysis. BioPsychoSocial medicine. 2020 Dec 1;14(1):1.
7 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.
8 Borstelmann NA, Rosenberg SM, Ruddy KJ, Tamimi RM, Gelber S, Schapira L, Come S, Borges V, Morgan E, Partridge AH. Partner support and anxiety in young women with breast cancer. Psycho‐Oncology. 2015 Dec;24(12):1679-85.
9 Shrout MR, Renna ME, Madison AA, et al. Relationship satisfaction predicts lower stress and inflammation in breast cancer survivors: A longitudinal study of within-person and between-person effects [published online ahead of print, 2020 May 19]. Psychoneuroendocrinology. 2020;118:104708. doi:10.1016/j.psyneuen.2020.104708
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