Stress: A New Cancer Risk Factor?
Written by: Medscape staff Impact Factor with F. Perry Wilson - February 19, 2025
This is fundamentally a study about stress, and so the most important thing that was measured was the women’s level of stress across four domains: daily stress (this is the everyday stuff, such as work, family, and so on), racial discrimination, social isolation, and neighborhood deprivation.
In the paper “Multilevel Stressors and Systemic and Tumor Immunity in Black and White Women With Breast Cancer,” appearing February 14, 2025 in JAMA Network Open, from Stefan Ambs of the National Cancer Institute and colleagues.
It’s a study of 121 women with breast cancer (primarily stage 1 and 2), with a mean age of 56 years, comprising 65 women who describe themselves as White and 56 who describe themselves as Black.
Although formally this is a cohort study, one could refer to it as a “deep phenotyping” study, or an “-omics” study. Essentially, this study measured a slew of biomarkers in the blood, in the cancer, and in the tissue surrounding the cancer. We’re talking 92 immune-oncologic protein markers and thousands of DNA and RNA markers.
This is fundamentally a study about stress, and so the most important thing that was measured was the women’s level of stress across four domains: daily stress (this is the everyday stuff, such as work, family, and so on), racial discrimination, social isolation, and neighborhood deprivation.
These four sources of stress were linked to three broad outcomes: immune function writ large, immune function in the area around the tumor, and the biology of the tumor itself.
There’s a lot here, obviously, so here is the headline version. Broadly speaking, increased levels of stress screw up the immune system in ways that dramatically improve the environment for cancer cells.
The response to stress here is a bit complicated. In some ways, stress increases activity in the immune system — which would seem like a good thing. The immune system doesn’t only fight off bacteria and viruses, it also identifies cells that are misbehaving in your body and kills them before they can kill you. But the way stress revs up the immune system is not helpful in preventing cancer. More stress leads to higher levels of things like angiopoietins, which are substances that promote the growth of blood vessels into tissues. Targeting angiopoietins is a mainstay of cancer therapy, because tumors need blood vessels to sustain their growth, so the fact that stress increases their production is very much a bad thing.
What about the so-called “local immune microenvironment”? This is essentially the cells and tissues right around the cancer — the neighborhood where it is growing. To see what was happening here, researchers looked at the RNA produced by the nearby cells. It’s not good. The authors found that while some immune cells, such as M1 macrophages, are ramped up, so are M2 macrophages, which actually suppress immune function. Most concerningly, cells that are particularly good at eradicating tumor cells — known as natural killer cells and follicular helper T-cells — are downregulated. If the immune system is the police force in your body, stress seems to fire the best detectives and replace them with desk jockeys who would rather eat donuts than pound leather.
It should also noted that although racial discrimination, social isolation, and neighborhood deprivation all had significant relationships with some pro-cancer markers, simple prolonged daily stress had the most consistent relationship across all the domains. Which makes sense, honestly. After all, things like racial discrimination, social isolation, and neighborhood deprivation increase stress levels — that’s probably part of the reason they have such adverse outcomes on health.
As for people with cancer, sure, it’s easy to say “don’t stress.” It’s harder to practice it. There are studies that have evaluated yoga and mindfulness meditation in cancer, with some encouraging results. Of course, that won’t be right for everyone. Finding out what reduces that “perceived daily stress” in your own life — whether it’s yoga or golf or spending time with loved ones or playing video games — is a worthwhile endeavor. Your body, and your local immune microenvironment, will thank you.
The Many Faces of StressStress manifests differently depending on the individual, influencing many biological processes that begin in the brain and spread through nearly all body systems – including the adrenals, thyroid, neurotransmitter systems, digestive system, and heart. Consistent stress over long periods of time can become a serious threat to maintaining lifelong wellness as so much energy is channeled into coping, ultimately leading to exhaustion.
The Stress Response: A Coordinated Series of Events
Neurotransmitters (or chemical messengers) are released, triggering an increase in emotional response and influencing memory, concentration, inhibition, and rational thought.
The adrenal glands pump out a group of hormones known as glucocorticoids—including the primary stress hormone cortisol—which marshal the heart, lungs, circulation, metabolism, and immune system.
The thyroid gland when imbalanced, pumps out hormones that accelerate metabolism, producing symptoms such as occasional sleeplessness, nervousness, and exhaustion.
Sex hormone levels may be reduced with stress, thereby reducing libido and sexual function. Acute stress may also cause a woman’s menstrual cycle to be irregular.
Glucose metabolism may fluctuate with stress as the liver releases stores of glucose into the blood stream and the pancreas decreases insulin secretion, increasing blood sugar levels for needed energy.
Heart rate increases during stress as the heart pumps more blood throughout the body.
Respiratory function may be altered with stress. In some individuals breathing rate increases.
The coordinated activities involved in digestion can be slowed down as energy is diverted in the stress response, possibly resulting in stomach discomforts.
Chronic stress is defined as inappropriate stress experienced frequently for a duration of time. Physiological responses to chronic stress allow an individual to adapt to the heightened stress level, a process called allostasis. An overactive stress response, characterized by agitation and inflammation, progresses into an inadequate stress response, characterized by fatigue and suppressed immunity, with a continuum of identifiable behavioral and clinical markers. Reducing chronic activation of the bodyʼs stress response can help to prevent stress-induced disease states and to promote healthy aging.
Botanical interventions called adaptogens have been used since ancient times to counteract physiological adaptations to the stress response. These herbal adaptogens support normalization of stress-induced biochemical and organ function changes to provide a safe and effective therapeutic approach to support health and well-being.
Adaptogens are herbs and natural substances that help the body adapt to stress, balance hormones, and support overall well-being. Below is a summary of key adaptogens and their benefits.
1. Ashwagandha (Withania somnifera)Function:
Reduces cortisol (stress hormone)
Supports thyroid function (beneficial for hypothyroidism)
Enhances energy, endurance, and sleep quality
May support hormonal balance (estrogen, testosterone, progesterone)
2. Rhodiola RoseaFunction:
Increases mental clarity, focus, and energy
reduces fatigue, anxiety, and depression
Supports physical endurance and workout recovery
Helps with altitude sickness and oxygen utilization
3. Holy Basil (Tulsi)Function:
Lowers cortisol and stress levels
Supports immune function and respiratory health
Reduces inflammation and oxidative stress
Helps regulate blood sugar and metabolism
4. Maca Root (Lepidium meyenii)Function:
Balances hormones (supports estrogen, progesterone, testosterone)
Boosts libido and fertility (for men and women)Increases energy and stamina
Supports mood and mental well-being
5. Ginseng (Panax ginseng & Panax quinquefolius)Function:
Boosts energy, focus, and cognitive function
Supports immune system and physical stamina
Regulates blood sugar and metabolism
Helps with stress resilience
6. Cordyceps MushroomFunction:
Improves energy, stamina, and oxygen utilization
Supports lung and respiratory function
Enhances immune system and endurance
May support anti-aging and cellular repair
7. Lion’s Mane MushroomFunction:
Supports brain health, cognition, and memory
Promotes nerve regeneration (NGF - Nerve Growth Factor)
Helps reduce anxiety and depression
May support gut health and inflammation reduction
8. Eleuthero (Siberian Ginseng)Function:
Improves mental and physical endurance
Supports immune system and stress resistance
Helps regulate blood sugar and circulation
May aid athletic performance
9. Schisandra BerryFunction:
Protects the liver and detoxification pathways
Enhances mental clarity and focus
Balances mood and stress response
Supports immune and respiratory health
10. Astragalus RootFunction:
Strengthens the immune system
Supports heart and kidney function
Promotes wound healing and recovery
May help with anti-aging and longevity
11. Reishi MushroomFunction:
Calms the nervous system and supports sleep
Strengthens the immune system
Reduces inflammation and oxidative stress
Supports liver function and detoxification
12. Shatavari (Asparagus racemosus)Function:
Balances female hormones (supports estrogen, fertility, and menstrual cycles)
Nourishes the reproductive system
Supports digestive health and hydration
Helps with stress adaptation and immunity
How to Choose the Right Adaptogen?For stress & anxiety: Ashwagandha, Holy Basil, Rhodiola
For energy & stamina: Rhodiola, Ginseng, Maca, Cordyceps
For brain health & focus: Lion’s Mane, Rhodiola, Ginseng
For hormone balance: Maca, Shatavari, Ashwagandha
For immune support: Reishi, Astragalus, Schisandra
References:
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<https://youtu.be/W-r_wG477gI> IFM Adaptogens