Stress reveals survival patterns in women with breast cancer
By Aaron Levin, Science Writer
Health Behavior News Service
SEATTLE — Women with breast cancer who have an outlet for stress may be able to reduce their risk of dying of the disease, according to an expert whose research found a link between mortality and the stress-induced hormone cortisol.
“Cancer is a stressor to the whole person as well as to the body,” said David Spiegel of Stanford University’s School of Medicine. Spiegel discussed his findings at the American Association for the Advancement of Science’s annual meeting over the weekend. “Cancer mortality is actually just 50 percent, but everyone thinks they’re going to die from it.”
Women with breast cancer face major stress as they cope with the disease and with changes in their lives. Stress initiates a series of chemical events in the body, including the release of the hormone cortisol, which in turn affects the brain, liver and other organs.
Ordinarily, cortisol levels are highest in the morning and lowest in the evening. But psychological factors can alter that pattern. High cortisol levels throughout the day are linked to depression, while low levels all day are common among those with post-traumatic stress syndrome.
Spiegel took salivary cortisol samples throughout the day in breast cancer patients. Two-thirds showed an abnormal pattern, peaking at times other than the morning. Patients whose cancer has spread have higher, flatter cortisol levels, especially at the end of the day. Those with abnormal patterns died sooner than those with a typical cortisol pattern, Spiegel found.
“With only a three-day test following diagnosis, we could predict survival up to seven years later,” Spiegel said. “Forty percent of the patients with abnormal cortisol patterns survived, compared to 60 percent of the other patients. Disrupting the daily cortisol rhythms increased the risk of cancer progression.”
Higher average cortisol levels were also associated with greater disease severity and with lower social support.
Women often tried to suppress their stressful emotions, which worsened their condition. Expressing stress appeared to normalize cortisol levels. An increased ability to process negative emotions, even briefly, was helpful, Spiegel said. Women who allowed themselves to express anger, frustration or sadness for periods of just a few seconds had more normal cortisol patterns, he said.
“Helping people handle the stress of cancer can help patients live longer,” Spiegel said. “Such help includes expressive group therapy, building bonds with other women in the same situation, expressing their emotions, detoxifying dying, using self-hypnosis for pain and reordering their priorities in life.”
Only half of current clinical trials show benefits, he added,
“but no studies show that psychotherapy kills people.”
Center for the Advancement of Health
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