Other stressors include external factors such as early life adversity, exposure to certain environmental conditions, poverty, discrimination... Serious health issues, such as a cancer diagnosis in oneself or a close friend or family member, can also cause stress.

The body responds to external stressors by releasing stress hormones (such as epinephrine and norepinephrine) that increase blood pressure, heart rate, and blood sugar levels. This response, often referred to as the fight-or-flight response, helps a person act with greater strength and speed to escape a perceived threat.

Although the fight-or-flight response helps the body manage momentary stress, when this response is caused by long-term, or chronic, stress it can be harmful. Research has shown that people who experience chronic stress can have digestive problems, heart disease, high blood pressure, and a weakened immune system. People who experience chronic stress are also more prone to having headaches, sleep trouble, difficulty concentrating, depression, anxiety and getting viral infections.

Although chronic stress can lead to many health problems, whether it is linked to cancer is not clear. Studies conducted to date have had varying results. Even when stress appears to be linked to cancer risk, the relationship could be indirect. For example, people under chronic stress may develop certain unhealthy behaviours, such as smoking, overeating, becoming less active, or drinking alcohol, that are themselves associated with increased risks of some cancers.

Laboratory studies have found that norepinephrine, released as part of the body’s fight-or-flight response, stimulates angiogenesis and metastasis. This hormone may also activate neutrophils, a type of immune cell. In some cases, neutrophils can help tumours grow by shielding them from the body’s immune system; they may also “awaken” dormant cancer cells.

Chronic stress may also lead to the release of a class of steroid hormones called glucocorticoids. Glucocorticoids may increase metastasis and resistance to chemotherapy. They may also prevent the body’s immune system from recognising and fighting cancer cells.

Although some studies have reported decreased survival among people with cancer who are experiencing stress, the evidence that stress directly affects survival remains weak overall.

Emotional and social support can help patients learn to cope with stress. Such support can reduce levels of depression, anxiety, and disease and treatment-related symptoms among patients.

There is some evidence that successful management of stress through social support is associated with better clinical outcomes for people with breast cancer and tumour progression in ovarian cancer.

Another approach to cope with stress is by being physically active. The American College of Sports Medicine found evidence to conclude that moderate-intensity physical activity during and after cancer treatment can reduce anxiety and depressive symptoms among cancer survivors.

Some expert organisations recommend that all cancer patients be screened with an appropriate tool, such as a distress scale or questionnaire, soon after diagnosis as well as during and after treatment to gauge whether they need help managing stress or are at risk for distress.

For more information please contact Grupo HPA Saude on (+351) 282 420 400.