An NCI-designated Comprehensive Cancer Center
By Dory Benford | April 13, 2017
There is no question stress can lead to numerous health problems: high blood pressure, anxiety, depression, heart disease and obesity — to name a few. But can chronic stress lead to cancer?
April - Minority Month - Chavez 3 Noe Chavez, Ph.D.
It is a complicated question, but the association between stress and cancer seems to surface when people turn to behaviors like overindulging in alcohol, overeating unhealthy foods and smoking to cope.

All of these behaviors are common — albeit unhealthy — responses to stress, and all are associated with an increased risk of cancer. And while every community experiences stress, its effects are perhaps most deeply felt in minority and underserved communities.

Noe Chavez, Ph.D., a community psychologist at City of Hope, explains why members of these communities are so stressed, and how it may be affecting overall health.

1. How does stress affect the body?

When you experience stress, it throws certain hormones in the body, like cortisol, out of balance. When that imbalance becomes chronic, it can impair mental function, blood pressure, digestion, your immune system and other bodily functions.

2.  How might chronic stress affect underserved communities?

African American, Latino, Asian, immigrant and poorer, rural white communities face toxic stress more than other communities.

People in these areas are more likely to be exposed to stressors such as poverty, violence, high incarceration rates and fewer educational opportunities. When you are immersed in that environment, it’s no surprise that you are more likely to experience chronic stress.

And you don’t necessarily have to experience a trauma firsthand to experience the stress associated with the event. Even if you are not physically suffering from a racist encounter or a police shooting, witnessing the event and the impending fallout can cause you to experience stress vicariously.

The issue of coping with stress in unhealthy ways is another challenge people in underserved communities face. They often lack the resources, education and time necessary to effectively cope. They’re just in survival mode. So they may turn to eating — and overeating — unhealthy foods, smoking, engaging in risky sexual practices and using drugs.

The dramatic rise in the abuse of opioids over the past few decades is an example of this. You see people overmedicating themselves or abusing their medication to cope, and instead of helping the situation, it only causes more stress.

3. At what age do people in these communities usually begin experiencing chronic stress?

Traumatic experiences in childhood set the stage for your psychological health for the rest of your life. Research has shown that when children experience traumatic events when they’re young, they are at increased risk, not just for psychological distress, but depression, anxiety and schizophrenia.

But the effects of chronic stress can actually begin prenatally, whereby the stress of the mother can affect the brain development of the fetus and growing baby. If we then think of the disparities and inequities that exist for mothers in different communities, we realize how these disparities in stressors can start impacting children even before they are born.

4. How does chronic stress relate to cancer?

In addition to unhealthy coping strategies known to heighten a person’s risk of cancer — like heavy drinking or smoking and unhealthy eating that can lead to obesity — stress impacts our bodies by affecting the immune system.

Our immune system is our bodies’ natural defense or protective mechanism from harmful invaders. Psychological stress or distress puts our immune system in jeopardy, and once the immune system is down, our body is more vulnerable to infections and chronic inflammation, and is less able to fight off diseases such as cancer.

One growing area in the fight against cancer is immunotherapy, which harnesses the body's own immune system to naturally fight the disease. So, thinking about building up our immune system by decreasing stress is not only important for prevention before the disease is present, but also during treatment, to help keep patients from developing complications with infections — or developing cancer again.

5. Is there an upside to stress?

When you talk about stress and coping, you also have to talk about resilience. It's possible to overcome trauma and use those experiences to develop the ability to withstand stressors you will face in the future. Fortunately, there are people that are able to move on and live otherwise healthy lives.
That saying, "What doesn't kill you makes you stronger," is true for many people.



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