Stress Management Interventions to Facilitate Psychological and Physiological Adaptation and Optimal Health Outcomes in Cancer Patients and Survivors

Abstract

Cancer diagnosis and treatment constitute profoundly stressful experiences involving unique and common challenges that generate uncertainty, fear, and emotional distress. Individuals with cancer must cope with multiple stressors, from the point of diagnosis through surgical and adjuvant treatments and into survivorship, that require substantial psychological and physiological adaptation. This can take a toll on quality of life and well-being and may also promote cellular and molecular changes that can exacerbate physical symptoms and facilitate tumor growth and metastasis, thereby contributing to negative long-term health outcomes. Since modifying responses tostressors might improve psychological and physiological adaptation, quality of life, and clinical health outcomes, several randomized controlled trials have tested interventions that aim to facilitate stress management. We review evidence for the effects of stress management interventions on psychological and physiological adaptation and health outcomes in cancer patients and survivors and summarize emerging research in the field to address unanswered questions.

Keywords: cancer health outcomes; cancer-related stressors; cognitive behavioral therapy; physiological adaptation; psychological adaptation; stress management intervention.

Figure 1

Biobehavioral model for stressors, psychological responses, neuroendocrine activity, and impact on peripheral tissue in cancer and their interactions with cognitive behavioral therapy (CBT)-based stress management interventions. Abbreviations: ACTH, adrenocorticotrophic hormone; HPA, hypothalamic-pituitary-adrenal; IL, interleukin; MMP, matrix metalloprotease; VEGF, vascular endothelial growth factor.