Thursday, December 21, 2006

Stress, Hormones and Cancer

I am fond of saying that "nothing ever gets better with emotional stress". Now, new research demonstrates this in the cancer realm. The overproduction of stress hormones/neurotransmitters causes cancers to grow in vitro and in a rat model.

Norepinephrine up-regulates the expression of vascular endothelial growth factor, matrix metalloproteinase (MMP)-2, and MMP-9 in nasopharyngeal carcinoma tumor cells.

Chronic stress promotes tumor growth and angiogenesis in a mouse model of ovarian carcinoma.

When the animals were tightly confined in plastic chambers for several hours at a time — causing a surge in their stress hormones — the tumours multiplied in size and number and were far more likely to metastasize. But blocking the stress hormones stalled the spread of the cancer. Moreover, the cancer grew more slowly in mice restrained in groups.
Cancer is way more than aberrant cells and perhaps can be significantly impacted by stress reduction practices and things like acupuncture that modulate the sympathetic nervous system (flight or fight neurotransmitter/hormonal response) to stress. However the scientific research controversies about this play out the public is not waiting for a scientific consensus. Studies show that two thirds of cancer patients are pursuing complimentary and alternative practice and mostly not telling their Doctors!.

All this to me is like the debate over energy efficiency and fossil fules. Until recently fuel economy was not given a lot of credence by American automakers and energy policy designers due to the erroneous assumption that energy efficiency does not have that big an impact (see link to Amory Lovins talking about energy policy). Meanwhile the Japanese automakers kept their eye on fuel efficiency (and quality) and are now the most successful car manufacturers. The same is true for therapies and practices that reduce the stress response in cancer. They may not cure cancer (although they might) but they sure can improve the quality of life while a person is alive and sustain the length of time that it takes for aggressive metastasis to develop.

A little history is in order here:

The controversy (over mind-body medicine) started 15 years ago when a study conducted by researchers at Stanford University's medical school found — quite to their astonishment — that in a decade-long assessment, women with metastatic breast cancer assigned to support groups had survived an average of 18 months longer than those receiving no psychological support. Scientists have been bickering ever since.

A study by researchers at Toronto's Mount Sinai Hospital a few years back, published in the New England Journal of Medicine, was touted as the nail in the coffin of the theory that the mind can influence disease. An attempt to replicate the Stanford study, it divided 235 women with metastatic breast cancer at random between those attending support groups where they could share their thoughts and fears with other patients and those left to their own devices. It found no difference in survival. What the research did show, however, is a huge improvement in the women's moods and perceptions of their pain.

“We were also able to achieve significant improvement with depression, anxiety, psychosocial adaptation,” says Molyn Leszcz, head of psychiatry at Mount Sinai and the study's principal co-investigator. “We didn't hit a home run. A home run would have been to show a survival effect. But we had evidence we were doing something right.”

This comes from a very well written feature story, Cancer in the Mind's Eye for the Toronto Globe and Mail newspaper. The author is struggling with cancer herself. She also explains her journey into healing with Alastair Cunningham a scientist who has integrated spirituality into group therapy. He has also written a book, The Healing Journey: Overcoming the Crisis of Cancer. It looks fascinating. If anyone has read this book let me know.