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Review
. 2019 May 1;125(9):1417-1431.
doi: 10.1002/cncr.31943. Epub 2019 Feb 15.

The impact of psychosocial stress and stress management on immune responses in patients with cancer

Michael H Antoni  1 , Firdaus S Dhabhar  2
Affiliations
Review

The impact of psychosocial stress and stress management on immune responses in patients with cancer

Michael H Antoni et al. Cancer. .

Abstract

The range of psychosocial stress factors/processes (eg, chronic stress, distress states, coping, social adversity) were reviewed as they relate to immune variables in cancer along with studies of psychosocial interventions on these stress processes and immune measures in cancer populations. The review includes molecular, cellular, and clinical research specifically examining the effects of stress processes and stress-management interventions on immune variables (eg, cellular immune function, inflammation), which may or may not be changing directly in response to the cancer or its treatment. Basic psychoneuroimmunologic research on stress processes (using animal or cellular/tumor models) provides leads for investigating biobehavioral processes that may underlie the associations reported to date. The development of theoretically driven and empirically supported stress-management interventions may provide important adjuncts to clinical cancer care going forward.

Keywords: adaptation; biobehavioral; immune; inflammatory; stress; stress management.

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Conflict of interest statement

Conflict of Interest

Dr. Antoni reports that he receives royalties from a Book on stress management in breast cancer patients. Dr. Dhabhar reports no conflicts.

Figures

Figure 1.
Figure 1.. Impact of Psychosocial Stress and Stress Management on Cancer-Relevant Immune Responses.
This model summarizes the potential impact of chronic stress (chronic psychosocial adversity, depression, negative affect, anxiety, and loneliness/social isolation) on neuro-endocrine processes (sympathetic nervous system (SNS) and hypothalamic-pituitary-adrenal (HPA) axis activation, which are associated with altered immune system activity (decreased immuno-protection, increased immuno-suppression and increased chronic inflammation), which may in turn hasten cancer progression and metastasis, and decrease quality of life and survival. The model also summarizes stress management resources (social support), and skills (adaptive coping and cognitive reappraisal, relaxation, mindfulness meditation, physical exercise), and pharmacologic interventions (beta-adrenergic blockade and COX2 inhibitors), which may act to decrease chronic psychosocial adversity and/or modulate neuro-endocrine and/or immune system processes that could contribute to positive health outcomes (decreased cancer progression and metastasis, and increased quality of life and survival). (Figure by FSD.)
See this image and copyright information in PMC

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