Dr Katarzyna Herbetko, Faculty of Medicine, Wroclaw Medical University, researches the impact of chronic stress on cancer progression.
Image credit: Wroclaw Medical University
A different picture emerges in cancers with a poorer prognosis, such as pancreatic and ovarian cancer. In this group, psychological distress and depression are more common and usually more severe. Importantly, psychological symptoms can sometimes precede the diagnosis of cancer, suggesting the involvement of biological mechanisms rather than just an emotional reaction to the diagnosis. At the biological level, inflammatory and cytokine mechanisms dominate, including elevated IL-6 levels and significant systemic stress.
As Katarzyna Herbetko notes, “Psychological distress is not just an emotion, but a factor that can contribute to physiological overload of the body and reduce the reserves necessary for the treatment process.”
The authors of the review emphasize that psychotherapy in oncology is not just emotional support. Data show that psychological interventions can:
reduce anxiety and depression, improve quality of life, affect stress and inflammation markers, such as cortisol levels and selected cytokines.
At the same time, researchers remain cautious in their interpretation. “There is no simple correlation: psychotherapy = longer survival. We see real, measurable biological changes, but the current state of knowledge does not allow for clear conclusions regarding mortality,” adds Katarzyna Herbetko. It is worth noting that the effect of psychological therapy may weaken after its completion, which indicates the need for long-term rather than episodic support.
The authors clearly point out the limitations of the available data:
heterogeneous methods of measuring stress, lack of meta-analyses allowing for precise quantitative conclusions, difficulty in separating stress as a biological factor from stress as a consequence of serious illness and treatment.
The most important message of the review is clear: chronic stress is not the patient’s fault. Rather, it is a factor associated with measurable biological processes that, like pain, malnutrition, or sleep disorders, can and should be addressed clinically.
The authors propose:
the systematic inclusion of psycho-oncology in the standard of care, routine screening for distress and fast-track assistance, support for partners and caregivers, development of digital interventions (e-health) and strategies to sustain the effects of therapy.
As Katarzyna Herbetko sums up: “Psycho-oncology cannot be an add-on. Chronic stress should be treated as a modifiable risk factor in oncology, analyzed in the context of complex biological, psychological, and environmental interactions.”
Source: Wroclaw Medical University