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Cancer Nursing:
doi: 10.1097/NCC.0b013e318289a6e2
Articles

Stressors, Stress Response, and Cancer Recurrence: A Systematic Review

Todd, Briana L. MA, MS; Moskowitz, Michal C. MS; Ottati, Alicia MA; Feuerstein, Michael PhD, MPH

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Abstract

Background:

Cancer survivors assume that stress plays an important role in cancer recurrence. However, the role of stress in the etiology of cancer recurrence remains unclear.

Objective:

A systematic review examining the causal role of exposure to stressors and/or stress response and cancer recurrence was conducted.

Methods:

The authors screened the scientific literature published from December 1979 through April 2012. Prospective studies and randomized control trials that examined the link between exposure to stressors and/or stress response and cancer recurrence were included in the review.

Results:

Fifteen studies examined exposures to stressors (life event questionnaires) and/or multiple indices of the stress response (mood, anxiety, depression, biological, and immune measures). The relationships between stressors and/or stress response and recurrence were observed as no relationship (80%), positive relationship (33%), and inverse relationship (27%). One of 3 randomized control trials reported a positive relationship between stress reduction and reduced risk of recurrence.

Conclusions:

The scientific literature to date indicates no clear evidence for a causal relationship between stress (measured as stressor exposure and/or stress response) and cancer recurrence. Although additional high-quality research is needed to provide a more definitive answer, the evidence to date does not support this hypothesis.

Implications for Practice:

Although at present, there is no evidence indicating a causal relationship between stress and cancer recurrence, attending to the reduction in a cancer survivor’s stress response can improve emotional well-being and quality of life.

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

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