A large number of epidemiological studies have supported the relation between stress/stressful life events and risk of cancer, however the number of involved variables and the long period of observation prevent with current technologies the definition of causal versus chaotic sequences of this hypothetical relationship. In addition the event will be spread over a period of several years.
For example it is known that “the big killers” (lung breast and colon cancer) are more common among people who had experienced stressful life events prior to the onset of their disease (compared to controls). Despite these data, the association between life events and cancer development is still highly controversial. The evidence available to date demonstrates the ability of many different psychosocial interventions to improve responses to the stress and adversity of the cancer experience in order to improve psychological adaptation.
Reduction in negative affect and social disruption and improvements in positive affect improve quality of life. Managing strategies have been linked to an improved physiological profile during and after treatment, which may increase the probability for disease-free survival in some cancers.
Health care providers can use a variety of screening tools, such as a distress scale or questionnaire, to estimate whether cancer patients need help managing their emotions or with other practical concerns.
However the role of psychotherapy deserve further investigation to establish the reliable effects of these interventions on clinical outcomes (recurrence and survival) in more cancer populations.
Emerging biotechnologies (immune-biology, microenvironment analyses, bioinformatics and microarray) could clarify the juncture of neuro-immune communications underlying inflammatory/stress-induced micro-environment and tumor promoting cell signaling. Different stress response led to enhance or reduce cellular immunity and resistance to cancer. The fight or flight stress response is one of nature’s under-appreciated defense mechanism that activates multiple psycho-physiological systems to promote survival.
The knowledge of biological mechanisms about the “fight or flight stress response and its adjuvant-like immune-enhancing effects” may provide a novel mechanism to promote or increase immune system-mediated tumor detection/elimination. The goals of innovative approach should be to facilitate the biological mechanism of endogenous immune-enhancement. A close collaboration between oncologists and psychologists is desirable to deal promptly and effectively with stress-induced cancer and stress during neoplastic diseases.