Stressful events and cancer - are they related?

[Guest guest]

BlankSource: The Moss Reports at http://www.cancerdecisions.com/121006.html

We received the following question from the leader of a divorce care recovery

group:

" I've heard that there is a connection between the emotional trauma of divorce

and the onset of cancer 3-5 years later and I'm looking for something of

substance on that. Are you familiar at all with this notion? "

First of all, it should be pointed out that there is no solid evidence of a

direct causative link of this sort between stress and the development of cancer.

Causation and correlation are two very different things. One's risk of

developing any disease can be raised by a number of factors, of which stress is

potentially one. This does not mean that stress causes the disease; it merely

means that stress may be correlated with an increased risk of developing it.

Divorce is intensely stressful. In fact, the Holmes and Rahe Depression Scale (a

measure used by psychologists and psychiatrists to assign relative stress

intensity values to various major life events) ranks divorce and marital

separation as second only to the death of a spouse as one of the most stressful

experiences one can have. Even receiving a jail term or probation ranks lower on

the scale than divorce or separation.

To see the full Holmes and Rahe Depression Scale (and an interesting article on

work-related stress accompanying it) please click or go to:

http://honolulu.hawaii.edu/intranet/committees/FacDevCom/guidebk/teachtip/stress\

..htm

Whether or not this kind of intensely stressful life event is associated with an

increased risk of cancer has been the subject of a great deal of investigation.

Several large studies have been conducted over the past ten years in an effort

to clarify whether or not stress contributes to cancer risk. Some have confirmed

that yes, there is an increased risk, while others have just as firmly

pronounced that no, there is not. What are we to make of this?

One great problem with such studies is that since they rely to a large extent on

participants' memory of past events, they are inherently undependable. Asking

people to look back over their lives and to recollect and rank the stressfulness

of past events is intrinsically subjective and impossible to standardize.

Nevertheless, even allowing for the methodological difficulties involved, there

does seem to be some data showing that the risk of developing certain cancers

can be modestly affected by severely stressful episodes. Breast cancer, in

particular, has been extensively studied in this regard, probably because it is

clearly established that hormonal influences play a strong role in the

development and progression of this disease, and hormone levels are of course

very clearly influenced by stress. One large Finnish study involving almost

11,000 women investigated the influence of stressful live events such as

divorce/separation, death of a husband or death of a close relative or friend on

the risk of breast cancer. The researchers found that these experiences were

indeed correlated with an increased risk of breast cancer (Lillberg 2003).

Other investigators have suggested that stress, in and of itself, is not a risk

factor for the development of cancer, but that certain behaviors associated with

coping with an episode of extreme stress – for example, smoking and drinking –

may be responsible for the slight increase in subsequent risk of cancer among

those affected (Li 2002).

Although the studies so far seem on the whole to be inconclusive, showing only

slight correlations between life stressors and the subsequent risk of developing

cancer, the possibility that stress and cancer are inextricably linked continues

to intrigue researchers.

--Ralph W. Moss, Ph.D.

References:

Li J, Johansen C, Hansen D et al. Cancer incidence in parents who lost a child:

a nationwide study in Denmark.Cancer. 2002;95(10):2237-42

Lillberg K, Verkasalo PK, Kaprio J, et al. Stressful life events and risk of

breast cancer in 10,808 women: a cohort study. Am J Epidemiol. 2003;157(5):415-2