Stress and cancer

The stress of having cancer can be felt at every point along the way.

  1. The stress of having cancer
  2. Most stressful points of a cancer journey
  3. How can stress affect your body?
  4. How to manage stress

The stress of having cancer

Life is full of everyday stresses which come from many different angles creating in general, a high level of emotional unrest.

However, when cancer strikes, the stresses a person with cancer and their caregiver will experience are of an entirely different magnitude and depth.

The strain felt is produced from; the illness itself, tension in your relationships, stretched finances, heightened emotions along with worry and fear of the unknown.

The cruel thing about cancer is that every aspect of the disease and coping with the disease will cause additional stress on your body and mind.

The immense pressure you feel is your body’s reaction to the significant changes you are forced to endure on a physical, emotional and mental level.1

The compounded stress felt as a result of cancer, happens more often than not at a time in your life when you were probably already stressed out; busy and running on high adrenaline, trying to keep up with the do-it-all, have-it-all modern lifestyle.

Then symptoms occur, cancer has happened you have to deal with all its consequences meaning your stress levels will only escalate.

The type of stress of having cancer is the most challenging form due to its ‘high-demand and low-control’ nature.

According to the ‘demand-control’ theory psychologists use to try to define and explain stress, when the burden is great and the outcome is difficult to gain any control over, you will suffer the greatest impact of stress in your life.2

Upon a cancer diagnosis, you are faced with stressors from every angle;

  • the uncertainty of a potentially life-threatening illness
  • the resulting impact upon relationships
  • work and finances
  • the demands of treatment and side effects
  • and any lasting body image issues.

There will also be worries surrounding the lasting impact that cancer will have on your soul, how will cancer impact you as a person?

The indefinite uncertainty will cause an ongoing strain as the threat of reoccurrence will be ever-present.

Even with the best medical treatment and improvements to your lifestyle, there are no guarantees as to what the future holds.

The truth is that cancer represents an extreme psychological burden for the patient.3

Such serious mental distress is experienced by most people with cancer.

For some this may be temporary and will pass, but for many cancer-induced stresses will lead to the provocation of depressive symptoms4 such as anxiety and depression.5

Most stressful points of a cancer journey

A cancer ‘journey’ has many pressurised points with both short-term and long-term stressors,6 which will test your resolve at every turn along the way.

You will experience the stress in different ways, for example acute stress is felt when receiving a concerning diagnosis or hearing the results of a scan and can be a shockingly painful assault on your mind and body.

Or, alternatively stress can become prolonged and become the backdrop to your life over weeks, months or even years.

This often happens when you must cope in the long-term with lasting side effects, the threat of reoccurrence or with the adjustment to any changes in your body image.

Stress of cancer reoccurrence

The intensity of each transition point of the journey every patient has to face will differ.

It is widely recognized that the stress produced in reaction to the initial diagnosis is the most difficult to deal with because the newly diagnosed fears the possibility of pain and death.7

Prior to diagnosis, the suspicion of cancer can also produce a strain of almost equal significance as the patient deals with their own internal struggle of doubting, fearing and denying early symptoms.

The emotional roller-coaster of uncertainty then continues as the investigations to discover the type, stage and prognosis take their time.

Then, there will be the pressure of making urgent and important treatment choices with the crucially ‘right’ decisions needing to be decided upon.

You will find yourself up against the success rate statistics and the impact any possible side effects will have upon your life in survivorship.

When treatment stops there will be another difficult time to get through as many patients feel the stress of not having the safety net of regular monitoring and contact with their medical team to reassure them.

The post-cancer phase of survivorship poses the new challenges of re-building a new life and restoring health and wellbeing in the shadow of a possible reoccurrence.

If sadly this does happen and the cancer progresses to the point when it is re-defined as a terminal illness, this clearly will cause untold stress upon the patient themselves, their caregiver and their families.

The strain will then continue for those left behind for an undefined length of time as their grief takes over and they try to adjust to a life with loss.

How can stress affect your body?

When we experience stress, it is essentially the body’s reactions to the feeling of being overwhelmed by the situation and overloaded by the current demands.8

Interestingly, both the emotional distress and physical strain your body experiences will initiate the body’s automatic nervous system,the inbuilt survival mechanism designed to prime you for action when put under extreme pressure.

This is because your body cannot differentiate between the threat your thoughts create and the physical strain an illness places upon your system.9

When under such a significant burden of stress, your body experiences a physical response to the trigger of distress.

Your heart rate increases, your breathing quickens, your muscles tense as your digestion system and immune system shut down.

Stress and cancer

Your body’s focus then switches from the normal status of rest and repair to fight or flight response.

Your whole system becomes primed by the release of sugar and cholesterol into your bloodstream along with hormones such as insulin, adrenalin, cortisone and endorphins.10

In the short-term, the energy that floods your body results in positive effects such as; a heightened awareness, a readiness for action and the initiation of innate protective factors.

These mechanisms would have been crucial survival tools for our ancestors when faced with a hunt or attack.The worries embedded in your anxiety are born out of the emotional reactions you have to the profound changes in your life.

Even for modern humans, a little stress can be a positive because it kick-starts our bodies to be able to cope with the short-term stressors we face in our daily lives such as meeting a deadline or catching a bus.

However, in recent times we are invariably placed under so many stresses, with little reprieve, that make us feel torn and under pressure as we are pulled in different directions by the demands of work, parenting, money worries, relationships etc.

When there is little time for true relaxation, the stress we experience becomes chronic and overwhelming as our cortisol or adrenaline response becomes permanently switched on and our bodies are locked into a heightened state of alertness.

The result is that stress can disrupt the body’s basic state of health interrupting the harmony of the body and as its usual functions.11When anxiety takes a grip of you it can be paralysing both physically and mentally.

There is a growing body of research into the effects stress can have upon the body, but this area of research is yet to confirm a direct link with major diseases such as cancer.

The general consensus is however, that chronic stress is not good for the body and mind.

In fact, the more stress you experience, the more your health could suffer as a consequence.12

Significant health problems we do know that can result from stress are issues such as;

  • inflammation
  • high blood pressure
  • digestive problems
  • headaches
  • fatigue
  • anxiety
  • depression13
  • a noticeable deterioration of physical appearance
  • skin rashes
  • an increase in infections
  • either weight loss or gain14
  • a loss in concentration.15

However, the general low-level overall health issue stress is responsible for is a feeling of being tense, frazzled and worn out.

How to manage stress

How successful we are in handling the demands of the many psychosocial stressors cancer can throw at us depends upon the characteristics of our personality, the past experiences we have faced, our culture and belief system16 along with the support network we have around us.

Support when facing cancer

Despite the innate ability to cope, which everyone has, the challenge to overcome all the stresses you will experience from multiple angles on top of suffering from any resulting mental health challenges is significant, and for many, overwhelming.

Your body’s response further adds to the difficulties you face.

When you are overstressed and/or suffering from anxiety and depression you are likely to have a lower rate of the chemicals released by your body to help you cope in the face of adversity such as; serotonin, noradrenaline and dopamine.17

Many of us will fall fowl of typical coping strategies in response to extreme stress which are clearly not healthy and are classed as ‘maladaptive’.

In reaction to the hyper-stimulation assault your mind has to cope with from the intense thoughts and heightened emotions.

The first coping mechanism many people will turn to is using alcohol and/or prescription drugs as a crutch to dull the painful experience.

As the stress escalates, our self-esteem and self-worth become negatively impacted and we don’t look after ourselves and our needs properly.18

When we are under extreme stress, the way we eat and drink can also suffer.

Impact of stress during cancer

As the stress escalates, our self-esteem and self-worth become negatively impacted and we don’t look after ourselves and our needs properly.18

The digestion system in some can slow, resulting in loss of appetite, whilst others overeat to fill an emotional hole.

Almost always our food choices will suffer as we reach for the convenient choice or simply eat mindlessly.

The irony is that the totality of these maladaptive forms of coping such as; a poor diet of processed foods, smoking, too much alcohol, tobacco, sugar, caffeine along with prescription drugs and a lack of exercise only mean that the body becomes even more stressed.

All of these lifestyle behaviours are associated with chronic inflammation19 and are risk factors for poor health and illness over the long-term.20

Yet there are those who seemingly can cope significantly better than others and the question therefore is, what do they do or think which enables them to cope in a positive way?

The answer lies in a multifaceted, determined approach to stress management.

People who cope well in such situations tend to be optimistic in their outlook and actively seek out the good in every situation.

They are flexible21 enough to be able to reframe their take on the situation positively and can regulate their emotional response accordingly, a skill which is critical in fostering resilience.22

They have the ability to detach themselves to the point that they are aware enough of the crisis they are in to be able to act in a way that will increase their chances of recovery.

For example, they actively look for the escape route out of the situation by seeking the best treatment plan possible and adjusting their lifestyles accordingly.

They are hopeful that outcomes will be good, yet they are willing to live the best life they can in the here and now.

They are able to find acceptance within themselves regarding what cannot be changed.

When you are highly stressed it does not feel good and you can tell when your body is under a huge amount of pressure, this is your body crying out to be better looked after.

There are many active coping styles which anyone can adopt to help them get through their tough times.

Typically, people react in an all or nothing response,23 either trying to actively manage their stress or alternatively by burying their heads in an attempt to try to ignore the problem.

Bear in mind, your efforts to cope with stress do not have to be perfect and by making a little effort to consciously be good to yourself it will help you survive better.

First focus upon the basic stress relievers for your body and mind;24 eat well, get enough sleep and do some exercise.

Try then to take a holistic approach to stress management which focuses upon improving your wellbeing.

By learning relaxation techniques such as; mediation, visualization, deep breathing techniques, progressive muscle relaxation and yoga you will feel stronger and more in control.

Seeking support from your friends, family, support groups and from professional counselling will help you handle your stress by enabling you to release your built-up tension through the natural stress relievers of talking and crying.25

Complementary therapies such as massage, acupuncture and reflexology are also good ways of provoking a relaxation response.

Finally, being aware that you are overly stressed, recognizing and accepting that you have a problem is the first step to coping better.

By actively planning how to deal with the pressures you face, seeking support and committing to doing things which will help, you will be better able to cope with the stresses you face.

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Recommend to others facing cancer, on support forums, social media, in person or by email. Thank you.

References

  1. Chaitow, L. (2017) How to overcome pain, 1st edn., London: Watkins Publishing.
  2. Furnham, A. (2012) Psychology, 50 Ideas You Really Need to Know, 2nd edn., Great Britain: Quercus.
  3. Karunanithi, G. et al. (2018) ‘Assessment of Psychological Distress and its Effect on Quality of Life and Social Functioning in Cancer Patients’, Indian Journal of Palliative Care, 24(1), pp. 72–77. [Online]. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5801634/ (Accessed: 27th September 2019).
  4. Pelletier et al., G., 2002. Quality of life in brain tumor patients: the relative contributions of depression, fatigue, emotional distress, and existential issues.. Journal of Neurooncology, [Online]. 57(1), 41-9. Available at: https://www.ncbi.nlm.nih.gov/pubmed/12125966 [Accessed 15 December 2018].
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  7. Grassi, L. et al. (2017) ‘Advancing psychosocial care in cancer patients’, F1000Research, 6(2083), pp. [Online]. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5717468/ (Accessed: 27th September 2019).
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  9. Tolle, E., 2006. A New Earth. 1st ed. United States of America: Penguin Books
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  11. Edgson, V. & Palmer, A. (2017) Good Gut, Great Health, 4th edn., London: Jacqui Small.
  12. Gawler, I., 2015. You Can Conquer Cancer. 3rd ed. Great Britain: Harper Thorsons.
  13. Edgson, V. & Palmer, A. (2017) Good Gut, Great Health, 4th edn., London: Jacqui Small.
  14. Furnham, A. (2012) Psychology, 50 Ideas You Really Need to Know, 2nd edn., Great Britain: Quercus.
  15. Harrison, E., 2018. Teach Yourself to Meditate. 2nd ed. Great Britain: Piatkus.
  16. Chaitow, L. (2017) How to overcome pain, 1st edn., London, UK.: Watkins Publishing.
  17. O’Connor, D., 2006. The Healing Code. 1st ed. Ireland: Hodder Headline Ireland.
  18. Juth, V. et al. (2008) ‘How Do You Feel? Self-esteem Predicts Affect, Stress, Social Interaction, and Symptom Severity during Daily Life in Patients with Chronic Illness’, Journal of Health Psychology, 13(7), pp. 884–894 [Online]. Available at: https://journals.sagepub.com/doi/abs/10.1177/1359105308095062 (Accessed: 27th September 2019).
  19. Heikkilä, K. et al. (2013) ‘Work stress and risk of cancer: meta-analysis of 5700 incident cancer events in 116 000 European men and women’, British Medical Journal, 346 (f165), pp. [Online]. Available at: https://www.bmj.com/content/346/bmj.f165 (Accessed: 25th April 2019).
  20. McEwen, B. & Sapolsky, R. (2006) ‘Stress and Your Health’, The Journal of Clinical Endocrinology & Metabolism, Volume 91(Issue 2), pp. Page E2 [Online]. Available at: https://academic.oup.com/jcem/article/91/2/E2/2843213 (Accessed: 20th May 2019).
  21. Kato, T. (2015) ‘The Impact of Coping Flexibility on the Risk of Depressive Symptoms’, PLoS One, 10(5), pp. e0128307 [Online]. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4444128/ (Accessed: 27th September 2019).
  22. Troy, A. S. et al. (2011) ‘Resilience in the face of stress: emotion regulation as a protective factor’, Resilience and Mental Health, Section 1 – Pathways to resilience (), pp. pp 30-44 [Online]. Available at: https://www.cambridge.org/core/books/resilience-and-mental-health/resilience-in-the-face-of-stress-emotion-regulation-as-a-protective-factor/C922920F58E6C5E4A4B2F9015AFC148A (Accessed: 25th April 2019).
  23. Janssen Oncology (2017) Managing Stress, Available at: https://www.cancer.com/managing-stress?ref=cancer-information/during-cancer-treatment/side-effects-of-cancer (Accessed: 27th April 2019).
  24. Kurzweil, R. and Grossman, T., M.D., 2011. Transcend, Nine Steps to Living Well Forever. 1st ed. New York, United States: Rodale.
  25. McKenzie, D., 2006. Understanding Depression. 7th ed. Poole, England: Family Doctor Publications Limited.

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