The role of inflammation is so significant in breast cancer survival that scientists continuously publish papers on identifying and mapping genes that “express” inflammatory factors in breast cancer patients. A January 2019 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.
In this article we will discuss the role of inflammation in spreading or recurring breast cancer and how stress management can halt the inflammatory response.
A new January 2019 study in the journal Cancer (2) 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.
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.
A November 2018 study published in the journal Einstein, (3) 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. These findings demonstrate the need for greater provision of alternative treatments for breast cancer symptoms. ”
Earlier research (4) 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.
Stress hormones and inflammation
Recently, doctors at the University of Miami published their research in the journal Future oncology (5) 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 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 (6) 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.
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 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.
3 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
4 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
5 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.
6 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.