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Severe stress may increase breast cancer recurrence.

Severe Stress May Increase Breast Cancer Recurrence

After successful treatment, breast cancer was more likely to recur in women who had experienced severe life stresses, according to a British study. A team led by Amanda Ramirez, M.D., of London's ICRF Clinical Oncology Unit and Department of Psychiatry at Guy's Hospital recorded what the researchers described as "adverse life events and difficulties" in 50 women whose breast cancer had recurred after treatment and in another 50 women who were still in remission. They then matched the women into pairs, based on factors that affect prognosis -- including type of surgery, whether they had received chemotherapy, involvement of lymph nodes, and tumor size -- and then compared the rates of recurrence.

They found that there was a significant association between "severely threatening life events and difficulties" and a recurrence of breast cancer, but that less severe life events and difficulties were not related to a relapse. According to their calculations, women who had suffered either a "severe life event or a severe difficulty" had a nine times greater risk of having a relapse than women who had not had such an experience. (A life event was considered severe if it "had threatening implications in the long term and consequences that were either pronounced or moderate and focused on the woman herself or jointly with someone else." Examples were the death of a husband or child or a divorce.)

A difficulty "of any severity" increased the risk of a relapse by nearly three; for nonsevere difficulties, which carried "little or no long-term threat," the risk was about the same. Emphasizing that a larger study was necessary to confirm their results, Dr. Ramirez and her colleagues concluded that their findings "suggest a prognostic [predictive] association between severe life stressors and recurrence of breast cancer." Whether severe stress affects overall survival was still unclear and exactly how stress influences a relapse of cancer "is unknown," they wrote.

They added that some researchers have suggested that the body's nervous, immune, and hormonal systems might stimulate the growth of dormant tumors that had spread from the original tumor to other parts of the body. Other factors, such as coping behavior and social support, might modify the "impact of severe life stressors," they suggested. "Understanding the nature of such interactions may have important implications for managing patients and for the development of cognitive and other psychological treatments aimed at helping patients with cancer adjust to the impact of their disease and cope with the consequences of subsequent severe life stressors."
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Publication:Nutrition Health Review
Date:Mar 22, 1989
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