Stress
Key Points
- Adverse or demanding circumstances, called “stressors”, can disrupt your internal balance and call on your body to activate a stress response.
- A prolonged stress response can produce a constant bodily imbalance that can be physically damaging.
- Unmanaged stress can increase the likelihood that the cancer will progress, as well as decrease your quality of life.
- Almost every category of complementary therapies has some useful stress-management approach.
- Consider seeing a professional such as a therapist, oncology social worker or oncology navigator to help you explore your stressful situation and identify an approach that is right for you.
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The Oxford English Dictionary defines stress as “a state of mental or emotional strain or tension resulting from adverse or demanding circumstances." Thus, stress is not so much a symptom as it is a state. Those adverse or demanding circumstances, called “stressors”, can disrupt your internal balance and call on your body to activate a stress response. This response is automatic and calls on every bodily system to bring the body back into balance. A certain amount of stress is normal—in fact, we couldn’t survive without the stress response. However, too much of a stress response over time can be damaging.
The Stress Response and Cancer
A prolonged stress response can produce a constant bodily imbalance that can be physically damaging. Organs and tissues begin to function differently in response to the continual outpouring of stress hormones and chemicals.
A prolonged stress response may compromise health and result in symptoms such as anxiety, depression and insomnia. The immune system is also affected—immune cells become preoccupied with triggering alarm reactions instead of doing their normal duties. With the body’s attention focused on dealing with stressors, the job of finding and killing cancer cells is neglected.
Under physiologic stress, the number of your neutrophils increases, while the number of lymphocytes decreases. Your neutrophil:lymphocyte ratio (NLR) is an indicator of stress. It is also a strong predictor of outcomes related to surgery for for breast, lung, and kidney cancers, as shown in these results from a mid-sized observational study:
- Higher NLR (3 or 4 or higher) is associated with a higher risk of relapse and perhaps mortality with breast cancer
- NLR 5 or higher is associated with a higher risk of relapse and mortality with kidney cancer
- NLR 5 or higher is associated with higher mortality with lung cancer
A prolonged stress response may compromise health and result in symptoms such as anxiety, depression and insomnia.
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People sometimes ask, “Did stress cause my cancer?” No one has a simple answer to this question. No good evidence shows that stress causes cancer. However, those of us with years spent caring for people with cancer believe that stress can affect the cancer itself as well as a person’s experience of having cancer. We know that the chemicals released in the stress response can speed up tumor growth.
These stress-response chemicals can also promote conditions, such as insulin resistance, which change the tumor microenvironment to the cancer’s advantage.
Chronically high levels of stress hormones can aggravate the mental anguish that many people with cancer experience, which then increases anxiety and depression. Then as emotional distress raises cortisol levels, high cortisol levels further increase distress. This ends up impairing your attention and memory, and making reasoning through problems and decisions difficult.
In sum, though stress may not cause cancer, it appears that unmanaged stress can increase the likelihood that the cancer will progress, as well as decrease your quality of life. If you think that stress is adversely affecting your current or future health, consider making managing stress a high priority in your integrative cancer care plan.
Though stress may not cause cancer, it appears that unmanaged stress can increase the likelihood that the cancer will progress, as well as decrease your quality of life.
Managing Stress
 Helpsy Health
Even when people are getting the best of cancer treatment, they often feel like they need more help with organizing their care and managing symptoms and side effects. Helpsy empowers members to take control of their health through a real-time virtual nurse support service. This service is available via mobile devices, a Helpsy website and automated phone calls.
Read more Based on a member’s health condition, Helpsy automatically creates a whole-health care plan. This plan considers the physical, emotional, social and socio-economic needs of each member. Members also have access to Helpsy’s community chat forum with other members and advocates to support and engage them throughout their journey.
Helpsy manages 500 unique symptoms and 20,000 remedy recommendations from over 30 healthcare modalities (such as patient education or nutrition), all backed by evidence-based research and science. Members can access Helpsy’s resources library for support services (including transportation, financial assistance, lodging and more) and self-care (emotional health, lifestyle changes, diet and nutritional counseling, fitness coaching, and support services).
In a clinical study, an intervention using many of Helpsy’s features led to significantly improved quality of life, less disruption to treatment, and cost savings..
Thanks to Helpsy, patients always have nursing support, right “in their pocket.”  
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Many tools for taming the stress response are available, many of which you can learn to do for yourself. Almost every category of complementary therapies has some useful stress-management approach. See Managing Stress, use the links in the Related Pages section below, or search our Therapy Summaries database, selecting "Stress" in the Symptoms box.
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In addition to complementary therapies, consider seeing a professional such as a therapist, oncology social worker or oncology navigator to help you explore your stressful situation and identify an approach that is right for you.
Finally, be gentle with yourself and recognize that the very nature of stress is that it often comes from circumstances that are out of your control. Look back long enough to learn from stress so that you can face forward and see a different way of responding to the inevitable stressors of life.
Integrative Programs, Protocols and Medical Systems
- Programs and protocols
- Traditional systems
Written by Laura Pole, RN, MSN, OCNS, and Nancy Hepp, MS; most recent update on October 21, 2021.
- Oxford English Dictionary. Stress. Viewed February 14, 2018.
- Alschuler LN, Gazella KA. The Definitive Guide to Cancer, 3rd Edition: An Integrative Approach to Prevention, Treatment, and Healing. Berkeley, California: Celestial Arts. 2010.
- Farkas J. PulmCrit: Neutrophil-Lymphocyte Ratio (NLR): Free upgrade to your WBC. EMCrit. May 23, 2019. Viewed September 25, 2021.
- Forget P, Machiels JP et al. Neutrophil:lymphocyte ratio and intraoperative use of ketorolac or diclofenac are prognostic factors in different cohorts of patients undergoing breast, lung, and kidney cancer surgery. Annals of Surgical Oncology. 2013 Dec;20 Suppl 3:S650-60.
- Lapedis M, Adler SR et al. Qualitative analyses from a prospective clinical study of a whole systems Ayurvedic intervention for breast cancer survivorship. Journal of Alternative and Complementary Medicine. 2014 May; 20(5):A75.
- Alschuler LN, Gazella KA. The Definitive Guide to Cancer, 3rd Edition: An Integrative Approach to Prevention, Treatment, and Healing. Berkeley, California: Celestial Arts. 2010; Alschuler LN, Gazella KA. The Definitive Guide to Thriving after Cancer. Berkeley, California: Ten Speed Press. 2013.
- Block KI. Life over Cancer: The Block Center Program for Integrative Cancer Treatment. New York: Bantam Dell. 2009.
View All References
More Information
- Georgetown University School of Nursing & Health Studies: Managing Mental Health after a Cancer Diagnosis
- Collaborative on Health and the Environment: Psychosocial Environment
- Psychedelic Support
- Triage Cancer
- Dr. Cynthia Li: Brave New Medicine
- Gurdev Parmar and Tina Kaczor: Textbook of Naturopathic Oncology
- Lise Alschuler and Karolyn Gazella: Managing Stress during Difficult Times
- Helpsy Inc.: Helpsy Health
- LifeExtension Nutritional Support: Diet and Lifestyle Considerations for Breast Cancer
- Block KI, Block PB, Gyllenhaal C: Integrative Treatment for Colorectal Cancer
- Integrative Cancer Review
- Martin L. Rossman, MD: Fighting Cancer from Within
- Julie Lusk: 30 Scripts for Relaxation, Imagery and Inner Healing–Volume 1
- Julie Lusk: 30 Scripts for Relaxation, Imagery and Inner Healing–Volume 2
- Barbara MacDonald, ND, LAc: The Breast Cancer Companion: A Complementary Care Manual: Third Edition
- Wayne Jonas, MD: Your Healing Journey: A Patient’s Guide to Integrative Breast Cancer Care
- Foundation for a Mindful Society: Mindful
- The New School at Commonweal: Ted Schettler: The Ecology of Breast Cancer
- Donald I. Abrams, MD, and Andrew T. Weil, MD: Integrative Oncology, 2nd Edition
- Keith I. Block, MD: Life over Cancer: The Block Center Program for Integrative Cancer Treatment
- Lorenzo Cohen and Alison Jefferies: Anticancer Living: Transform Your Life and Health with the Mix of Six
- Michael Lerner: Choices In Healing: Integrating the Best of Conventional and Complementary Approaches to Cancer
- Hillingdon Oncology & Palliative Care Team : Coping with Stress: The Distress Thermometer
- O. Carl Simonton, MD, James Creighton, PhD, and Stephanie Matthews Simonton: Getting Well Again
- Martin L. Rossman, MD: Fighting Cancer
- Joan Borysenko, PhD: Minding the Body, Mending the Mind
- NCCN Distress Thermometer and Problem List for Patients
- Martin L. Rossman, MD: The Healing Mind
- Julie Lusk, MEd: Wholesome Resources
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