Article written by Dr. Paul J. Rosch, President of the American Institute of Stress and Clinical Professor at New York University of Medicine and Psychiatry.
"This is one of the most brilliant articles I have read on the relationship between cancer and stress as a possible etiological factor of this disease. It contains historical observations on this subject, as well as scientific studies that point in this direction. I have divided it into several articles that we will be publishing."
Dra. Esther Ibáñez
The belief that cancer may be somehow related to stress or distressing emotions is as old as the documented history of medicine. Over 2,000 years ago, in his dissertation on tumors, De Tumoribus, Galenus observed that women who were melancholic were much more susceptible to cancer than other women, presumably because they had too much black bile (Melas chole). It was difficult to find much written about cancer in the English medical literature until 1701, at which time a British physician, Gendron, highlighted the effect of "disasters of life producing distress and sadness" as cancer-causing. Eighty years later, Burrows attributed the disease to "the restless passions of the mind with which the patient is strongly affected for a long period of time."
Early 19th-century physicians such as Nunn emphasized that emotional factors influenced the growth of breast tumors, and Stern noted that cervical cancer in women was more prevalent in sensitive and frustrated people. Walshe's treatise "The Nature and Treatment of Cancer" emphasized the "influence of mental misery, sudden reverses of fortune, and frequent melancholy attacks on the formation of carcinomatous material. One hundred years ago,
Snow reviewed more than 250 patients at the London Cancer Hospital concluding that "the loss of a close relative was an important factor in the development of breast and uterine cancer.".
I attach particular importance to these observations, because the practice of medicine a hundred or two hundred years ago was much more personalized. Physicians had to rely more on their own understanding of the importance of the patient's medical history, emotional background, and lifestyle, in contrast to today's emphasis on high-tech laboratory and imaging procedures in patient diagnoses. In addition, their education included literature, humanities, and philosophy, rather than the current emphasis on science. They were much more likely to know the patient's family, social relationships, and the influence of other psychosocial environmental factors. They also spent much more time observing and talking with patients, and asking pertinent questions about details, which is impossible in the frenetic pace of today's specialized and relatively superficial medical practice. Thus, thanks to much more thorough training, and a more personalized approach, we might well expect them to have had a greater sensitivity to and appreciation of certain subtle nuances that might suggest a possible link between emotional stress and cancer.
During the 20th century, interest was directed toward external agents as the cause of cancer. Today, a host of carcinogenic substances in the air we breathe, the food we eat, or various viruses have been incriminated. All these approaches imply some physical assault on us from the outside, according to the germ theory of disease, which is quite understandable. Pasteur's discovery of microbes and clinical achievements, and the proof offered by Koch's postulates have confirmed the direct causal relationships between microorganisms and infectious diseases. The subsequent success of various vaccines and the life-saving effects of antibiotics seemed to resolve the doubts. People get sick because something attacked them from the outside. Little attention has been directed to disease resistance or susceptibility. Few questioned why certain individuals exposed to the same tuberculosis bacillus, hepatitis virus, or carcinogens remained healthy.
However, over the past few decades, numerous clinical and animal research studies have continued to confirm the important influence that stressful emotions can exert in relation to the development and progression of various diseases, including cancer.
Some of the main characteristics of cancer-prone individuals appear to be frequent feelings of hopelessness and helplessness, inability to express anger or resentment, low self-esteem and sadness, or having suffered the loss of a significant emotional relationship. Everson et al. assessed hopelessness in 2,500 men and found that six years later there were almost 3.5 times as many cases of death from cancer or heart disease in those who had scored high on a scale measuring the level of hopelessness. Apropos of this discussion, I would like to focus on Snow's observation about the significance of the loss of an important emotional relationship as a precursor to cancer.
Implicit in Cannon's "fight or flight" theory is the premise that our automatic, involuntary responses to stress have developed progressively over man's evolutionary time. It is postulated that they represent adaptive changes that were essential for the survival of our ancestors when faced with a threat to their physical life. Adrenaline secretion and stimulation of the sympathetic nervous system causes pupils to dilate for better vision, blood clotting speeds up to reduce the loss of lacerations or internal bleeding, blood pressure and heart rate increase to increase blood flow to the brain to facilitate decision making, and carbohydrates and fats stored in the body are released to raise the blood glucose level for more energy. Blood circulation decreases in the digestive system, as digestion is not a priority, and increases in the large muscles of the extremities. This produces increased tension and strength in the arms and legs to aid in melee battle, or speed of locomotion away from a potentially dangerous scenario.
However, the nature of stress for modern man is not a potentially lethal physical encounter, with a saber-toothed tiger or a warring tribe every few months, but rather a great deal of emotional stress that often occurs several times a day. The tragedy is that these still often result in the same "fight or flight" responses that are not useful to our purpose.
It is not difficult to understand how these inappropriate responses to stress can contribute to "diseases of our civilization", such as hypertension, diabetes, heart attacks, strokes, peptic ulcers, muscle spasms, etc...
Many of our stress responses don't seem to make any sense in terms of providing any benefit. When very frightened, some people experience "goose bumps," or the erection of hair on the back of the neck, and what good is this response to us? However, stimulation of those same hair-erecting muscles is responsible for the arched back of a cat in a state of defense that confers a more ferocious appearance to its assailant. They also produce the bristling of the porcupine's quills, which provides a very effective defense mechanism. Thus, all of our stress responses undoubtedly served a useful purpose at some point during the long course of human evolution.
It is equally evident that we often overreact to stimuli with responses that are detrimental. We see this in the occasional development of deforming keloids during excessive scar formation in wound healing. Similarly, lip cancer can develop in clay pipe smokers at the site of heat-damaged tissue that is trying to repair itself. There are other cases in which adaptive evolutionary changes may end up being detrimental. In the chapter I wrote in 1958 in which I discussed Seyle's concept of "Adaptive Diseases" I referred to the theory of "opportunism" in the evolutionary process. This refers to the response of the organism to meet a need with whatever means are available, even if that response may ultimately prove detrimental. The example cited at the time was the enormous variation in the development of different horns in twenty-three species of African antelope. Some horns are obviously too small to be effective, such as those of the Duiker, while others are unwieldy, as in the kudu. As this tremendous variation is observed, the marked alterations in anatomical configuration and functional effect do not appear to serve any useful or rational adaptive purpose, and are more of a detriment. If I were to rewrite that article today, I would select the development of malignant tumors in man as perhaps a more dramatic example of "opportunism" in the evolutionary process, for the following reasons.
If I were to rewrite that article today, I would select the development of malignancies in man as perhaps a more dramatic example of "opportunism" in the evolutionary process, for the following reasons.
As one moves down the phylogenetic scale, the incidence of cancer progressively decreases, and is absent in primitive forms of life.
In contrast, the ability of the organism to regenerate injured or lost tissues increases proportionally. Simpler organisms, including some invertebrates, are capable of severing parts of their anatomy when injured. Obviously, this ability would have survival value only if the animal possessed an equally remarkable ability to regenerate the lost part with available cell remnants. Thus, a starfish can grow a new appendix, and a salamander or newt can grow a new tail or leg if it is cut off. Humans, however, have no such reparative or regenerative powers, except perhaps for the liver and spleen, which are similar in nature to organs found in the lower forms of life.
Human beings, however, have no such reparative or regenerative powers, except perhaps for the liver and spleen, which are similar in nature to organs found in the lower forms of life.
I believe that some cancers may represent a vestige of this primitive regenerative potential. When we suffer a loss or injury, an attempt to respond with similar replacement activities is triggered. Unfortunately, this new growth, or neoplasia, may become detrimental rather than functional. Experiments with chemicals that can produce cancer when applied to the skin or injected into laboratory animals and humans support this hypothesis. When these same carcinogens are injected into the leg of a salamander, it does not result in cancer, but surprisingly there is growth of a new accessory limb at that site. If the same carcinogenic substance is injected into the lens of the eye, the salamander will regenerate a new lens.
Thus, an identical carcinogenic stimulus can produce either intentional regeneration, or a fatal malignancy, depending on the evolutionary development of the organism.
Full article here
