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Breast Cancer Awareness Week 1: Stress and Cancer

Breast cancer is the second most common cancer in women after skin cancer. The estimated new cases in 2020 is 276,480 and the estimated death of the cancer in 2020 is 42,170. This cancer hits home with most of us as we know someone close to us or we have had and survived breast cancer. For me, my mom was a seven-year survivor before it came back, and I just recently lost a dear friend to a very aggressive form of breast cancer. I have a dozen of good, close friends who are now survivors on the breast cancer spectrum, so I am proud to be able to help spread the word on how important it is to keep up with your monthly breast checks as well as your stress management.

Based on data from 2015-2017 approximately 12.9 percent of women will be diagnosed with female breast cancer. This should be a good reminder to keep your health and wellness a priority in your life. The positive outlook is that the current 5-year survival rate is now at 90%.1 The research and protocols have changed over the years, even from when my mom went through treatment, that the hope for survival has shifted and more women are living longer and surviving longer.

New research2, using mice, have shown that stress hormones can increase breast cancer growth as well as diversifying it through the body, which can make it harder for the doctors to pinpoint and find the right treatment. Once it metastasizes and spreads to other areas it becomes another step in trying to find the right treatment for the patient. One thing that can help is to create a good stress management “tool-kit” to help you through the diagnosis, treatment and post treatment.

Medical News Today provided research3 regarding how chronic stress, stress that has been consistent with the person over a long period of time, can affect emotional and mental health, but also physical health. Many studies have linked chronic stress to enhanced cognitive impairment, increased issues with gut or digestive health as well as a higher risk of heart problems. Robert Stawski is an associate professor in the College of Public Health and Human Sciences at Oregon’s State University in Corvallis believes that his research shows how our reactions to stressful situations is what actually harms our brain health, instead of the actual stressful situation.

In 2013 a study published in the Journal of Clinical Investigation found that the activation of the master gene, ATF3 (the stress gene) which is important for helping cells adapt to stress, could be involved in helping breast cancer and other cancers spread through the body. Research has shown that exposure to stress can speed up the growth of cancer through the impact of this gene. Researchers know that the ATF3 is activated when all types of cells experience stress which can threaten their ability to maintain a constant state of homeostasis or balance within the body.

In normal conditions, triggering ATF3 can protect the body from harm by causing normal cells to commit suicide if there is a risk they have become permanently damaged by any stressful conditions like irradiation or lack of oxygen. However, when cancer cells are first present in the body, the immune system recognizes them as foreign agents and recruits immune cells to attack them. Early stages of cancer this will work; however, things can go wrong with the cancer cells send signals to immune cells that cause them to misbehave and that is what helps the tumor grow. Ohio State University researchers have found that cancer cells were able to switch on the ATF3 in the immune cells which caused these cells to malfunction and allow cancer cells to escape from the tumor and then spread to other areas of the body. Tsonwin Hai, a professor of molecular and cellular biochemistry at Ohio State University stated the following:

“If your body does not help cancer cells, they cannot spread as far. So really, the rest of the cells in the body help cancer cells to move, to set up shop at distant sites. And one of the unifying themes here is stress.”6

Tsonwin believes that if the body is in perfect balance, there really isn’t much of a problem. But when the body becomes stressed it will change the immune system and can increase the spread of the cancer cells within the body.

Researchers at the University of Illinois at Chicago have found that psychological stress may be a key component in the causation of breast cancer aggressiveness. Their team specifically researched black and Hispanic breast cancer patients and reported higher levels of stress and that stress was linked to their tumor aggressiveness. The team had asked the patients specific questions regarding their perceptions of fear, anxiety and isolation about two or three months after they were diagnosed. The results found that mental stress scores were higher in the Hispanic and black patients who also showed aggressive tumor growth.

Professor Hai is continuing her research and hopes her team can find a way to have the stress gene be a target for drugs that fight the spread of cancer. Her research has helped them better understand how tumor cells hijack the body’s own resources to promote cancer survival as well as and cancer spreading throughout the body. The ATF3 gene can be switched on and signals sent by cancer cells in multiple ways; radiation, chemotherapy, UV damage, a high-fat diet and even chronic behavioral stress are among the top culprits. Her team is planning more research to see how these and other stressors affect immune cells through switching on ATF3 and then changing them from attacking cancer cells, to helping them.

Another set of researchers in China at the Dalian Medical University have located a key mechanism, that chronic stress triggers, that fuels the growth of cancer stem cells, specifically in breast cancer mouse models. Their research was reported in the Journal of Clinical Investigation and showed that the hormone epinephrine may be the culprit. They also looked at a strategy to counteract any effects of stress on the cancer cells. The cells in the tumor can be killed, but if you don’t address and kill the stem cells or what the researchers call “mother cells” the tumor is going to metastasize and grow. This is one of the first studies to link chronic stress to the growth of breast cancer cells.

The researchers at the Dalian Medical University honed in on a specific hormone, epinephrine. In their experiments with mice, they found that the stressed out mice had a higher level of this hormone than their counterparts who were kept in a de-stressed state. Both groups of mice had breast cancer cells injected into their system, but the mice who were kept in a stressed state showed higher tumor growths and higher epinephrine levels than the control group. They also used a drug that blocked the epinephrine receptor (ADRB2) and found that those mice who received it had smaller tumors and their cancel cells were also lower.

Epinephrine binds to ADRB2 and the interaction boosts levels of lactate dehydrogenase, an enzyme that can give a muscle a push of energy in a dangerous situation. This can help a person either fight the threat or run from it. The consequence of this energy boost is the creation of an organic compound called lactate. In healthy people this is not a problem, but in those with cancer the harmful cells feed on this compound. This means if the person has chronic stress, they most likely have too much lactate dehydrogenase in their system and this can activate genes in cancer to grow and allow the cancer cells to thrive.

Professor Mohamed Bentires-Alj and his colleagues have a new study that appears in the journal Nature. They explain that their findings of the increased cortisol (stress) hormone can help doctors look at other types of assistance for their patients. He states; “These findings highlight the importance of stress management in patients and especially those with triple-negative breast cancer. Moderate exercise and relaxation techniques have been shown to correlate with enhanced quality of life and greater survival in patients.”8

After receiving a diagnosis of breast cancer you will be flooded with so many emotions and feelings. It is so important to be able to sit and feel through each and every one of them. Your anxiety, worry, dread or frustration and anger are all normal. There are techniques that will support you and help you reduce your stress so you can cope with the next steps in your plan. Stay tuned and you will learn some specific stress management techniques to help you or a loved one battling any type of cancer.



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