From Your Navigator

The Link Between Stress, Inflammation, & Cancer

A diagnosis of a life-threatening illness such as cancer is almost universally experienced as stressful. The negative effects of stress on psychological and health outcomes have received much attention.
June 2016 Vol 2 No 3
Cheryl Bellomo, MSN, RN, OCN, HON-ONN-CG
Oncology Nurse Navigator
Intermountain-Southwest Cancer Center
Cedar City Hospital
Cedar City, UT

A diagnosis of a life-threatening illness such as cancer is almost universally experienced as stressful. The negative effects of stress on psychological and health outcomes have received much attention. The relationship between inflammation associated with stress and cancer was known centuries ago and is now recognized as a characteristic of cancer.

Furthermore, cancer itself, and cancer-related treatment cause stress that promotes inflammatory processes, which in turn contribute to the exacerbation of cancer symptoms, the spread (metastasis) of cancer, and cancer recurrence (coming back). Research suggests that stress, inflammation, and psychosocial interventions can influence the development and progression of cancer.

Stress and Cancer

New research has shown that stress, and the stress response (the fight-or-flight response of the body to stress), are probable mediators of the effects of psychological factors on cancer, specifically on the growth and progression of cancer.

Stress has been defined as the experience of a negative life event, or the occurrence of an event without the ability to effectively cope with it. Stress can be characterized by our psychological and physiologic (the mind–body connection) responses to an event or circumstance that is perceived as threatening, harmful, or challenging.

Stress is normal, but when the repair mechanisms of the body-cells cannot catch up with the damage
caused by the stress, major inflammation can occur.
Stress increases inflammation at the cellular level of
our body and can contribute to changes in our health, including an increased risk for developing cancer.

Although some stress is considered beneficial, excessive stress that lasts a long time can result in inflammation in our body.

Inflammation & Cancer

Inflammation can be acute or chronic. Acute inflammation is the initial stage of inflammation, which involves activation of the immune system as a short-term protective response to help ward off infections. If inflammation lingers, over time chronic inflammation sets in and may lead to various illnesses, including cancer.

Evidence strongly shows that chronic inflammation precedes tumor growth and metastasis (spread of tumor). As reported in a research study published in 2009, the majority (90%-95%) of cancer cases have been linked to lifestyle factors (such as smoking, excessive weight, and inactivity) and the environment.1

Studies suggest that certain cancers develop in tissues that are severely damaged by chronic inflammation, such as lung cancer caused by asbestos or cigarette smoke; cervical cancer caused by human papillomavirus; gastric (stomach) cancer caused by H. pylori infection; liver cancer caused by hepatitis B or hepatitis C; and ovarian cancer caused by pelvic inflammatory disease.

Growing evidence suggests that stress and inflammation affect cancer progression and patient outcomes, but behavioral and psychosocial therapies that activate the stress response can alter the inflammatory mechanisms that promote the development and progression of cancer.

Psychosocial therapies include cognitive behavioral approaches to modify mood, improve one’s outlook, and evaluate stress and coping. Behavioral approaches to reduce tension, anxiety, and distress include relaxation training, mindfulness, meditation, yoga, and exercise.

Psychosocial interventions can help to develop and reinforce one’s coping skills, provide psychosocial support, model communication, facilitate relaxation, reduce stress and anxiety, promote general well-being, improve symptom management, and improve quality of life.

60-Seconds Stress Less Activities

  • Take 3 deep breaths, releasing your breath very slowly
  • Do a few favorite stretches
  • Share a joke and laugh out loud
  • Go outside and look at the sky or clouds
  • Take a walk
  • Read a motivating thought or quote
  • Sit and be quiet

Psychosocial interventions may significantly influence lifestyle behaviors such as smoking-cessation, physical exercise, and diet, which play a significant role in creating positive health outcomes in patients with cancer.

Ask Your Navigator

Nurse navigators can play a key role in assessing stress and coping skills, educating providers and patients to improve treatment-related symptom management, and provide resources to develop personalized interventions for individual patients.

Ask your nurse navigator about available resources to deal with stress, including support groups; exercise programs; and meditation, yoga, and wellness programs offered at your local cancer center or in your community.


  1. Aggarwal BB, Vijayalekshmi RV, Sung B. Targeting inflammatory pathways for prevention and therapy of cancer: short-term friend, long-term foe. Clin Cancer Res. 2009;15:425-430.

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