Stress reduction strategies in breast cancer: Review of pharmacologic and non-pharmacologic based strategies

Gosain, Rohit; Gage-Bouchard, Elizabeth; Ambrosone, Christine; Repasky, Elizabeth; Gandhi, Shipra

doi:10.1007/s00281-020-00815-y

Cited by 85Cancer, Stress, Anesthesia, and Immune ResponseCancer survivorship and careStress Responses and Cortisol

Stress reduction strategies in breast cancer: Review of pharmacologic and non-pharmacologic based strategies

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Gosain, Rohit, Gage-Bouchard, Elizabeth, Ambrosone, Christine, Repasky, Elizabeth, Gandhi, Shipra·2020·Seminars in Immunopathology

DOI 10.1007/s00281-020-00815-yPMC PMC7704484

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Abstract

Breast cancer is the most common cancer diagnosed in women. It is associated with multiple symptoms in both patients and caregivers, such as stress, anxiety, depression, sleep disturbance, and fatigue. Stress appears to promote cancer progression via activation of the sympathetic nervous system releasing epinephrine and norepinephrine as well as activation of hypothalamic-pituitary-adrenal axis releasing cortisol. These stress hormones have been shown to promote the proliferation of cancer cells. This review focuses on stress-reducing strategies which may decrease cancer progression by abrogating these pathways, with a main focus on the β-adrenergic signaling pathway. Patients utilize both non-pharmacologic and pharmacologic strategies to reduce stress. Non-pharmacologic stress-reduction strategies include complementary and alternative medicine techniques, such as meditation, yoga, acupuncture, exercise, use of natural products, support groups and psychology counseling, herbal compounds, and multivitamins. Pharmacologic strategies include abrogating the β2-adrenergic receptor signaling pathway to antagonize epinephrine and norepinephrine action on tumor and immune cells. β-Blocker drugs may play a role in weakening the pro-migratory and pro-metastatic effects induced by stress hormones in cancer and strengthening the anti-tumor immune response. Preclinical models have shown that non-selective β1/2-blocker use is associated with a decrease in tumor growth and metastases and clinical studies have suggested their positive impact on decreasing breast cancer recurrence and mortality. Thus, non-pharmacological approaches, along with pharmacological therapies part of clinical trials are available to cancer patients to reduce stress, and have promise to break the cycle of cancer and stress.

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Stress promotes the development of cancer.
“Measures to reduce stress appear to be extremely important, as many studies have shown that stress promotes the development of cancer [62,63,64,65,66].”
From The Effect of Vinyasa Yoga Practice on the Well-Being of Breast-Cancer Patients during COVID-19 Pandemic (2023) · cites this paper as [62]
The section “Stress promotes cancer progression” says stress promotes the progression of existing cancers through hormonal and immune pathways. It does not establish that stress promotes the initial development of cancer, as the citing sentence could imply. (LLM, conf=0.85)
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RETRACTED ARTICLE: Genetic manipulation of autonomic nerve fiber innervation and activity and its effect on breast cancer progression
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Holland (1999) · doi:10.1002/(sici)1099-1611(199901/02)8:1

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Authors: Gosain, R., Gage-Bouchard, E., Ambrosone, C., Repasky, E., & Gandhi, S.
Affiliations: Roswell Park Comprehensive Cancer Center (US)
Corresponding author: Gosain, Rohit
ORCID: Gosain, Rohit
Ambrosone, Christine
Repasky, Elizabeth
Gandhi, Shipra
Venue: Seminars in Immunopathology
Publisher: Springer Science and Business Media LLC
Published: 2020-09-18
Volume: 42
Issue: 6
Pages: 719-734
ISSN: 1863-2297 (ISSN-L)
1863-2300
DOI: 10.1007/s00281-020-00815-y
PMC: PMC7704484
OpenAlex: W3087281708
Cited by: 85
References: 197
Citations by year: 2026: 8 · 2025: 17 · 2024: 13 · 2023: 23 · 2022: 13 · 2021: 10 · 2020: 1
FWCI: 1.95
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0 (tdm)
creativecommons.org/licenses/by/4.0 (vor)
Locations: Seminars in Immunopathology (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Funders: National Institutes of Health (R01 CA205246, R01 CA099326)
Roswell Park Alliance Foundation, Roswell Park Cancer Institute
Breast Cancer Research Foundation
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Cancer, Stress, Anesthesia, and Immune Response
Health Sciences › Medicine › Oncology › Cancer survivorship and care
Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Keywords: breast cancer, stress reduction, beta-adrenergic signaling, beta-blockers, sympathetic nervous system, hypothalamic-pituitary-adrenal axis, cortisol, epinephrine, norepinephrine, complementary and alternative medicine, meditation, yoga, acupuncture, physical activity, herbal compounds, support groups, psychological counseling, tumor progression, metastasis, tumor growth, antitumor immunity, breast cancer recurrence
MeSH terms: Breast Neoplasms, Fatigue, Female, Humans, Hypothalamo-Hypophyseal System, Neoplasm Recurrence, Local, Pituitary-Adrenal System

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Stress reduction strategies in breast cancer: Review of pharmacologic and non-pharmacologic based strategies

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