The emotional distress associated with an anticipated traumatic incident is often greater than that encountered as a result of the physical event itself. Examples are a child awaiting a well-deserved spanking, or sitting in the dentist's waiting room before some procedure that is virtually painless.
The ability to regenerate lost or damaged tissue in lower forms of life obviously involves more than a simple local response. The message that tissue has been damaged or lost must be transmitted to higher centers of the central nervous system which in turn initiate appropriate and coordinated reparative responses.
With the male cerebral cortex more developed, loss of emotional well-being can be perceived as being as important or even more stressful than a physical separation.
The same signals can be sent to trigger the endocrine, immune, and central nervous systems and respond in some way to repair the damage. However, our attempts to stimulate replacement or intentional new cell growth are futile. What may result instead is new growth in the form of neoplasia that is malignant and beyond control.
What may result instead is new growth in the form of neoplasia that is malignant and beyond control.
On the Holmes-Rahe scale, the four most stressful life-changing events for everyone involve the loss of important emotional relationships, with the death of a spouse and divorce at the top of the list. If stress can cause cancer, one would expect affected individuals to have significantly higher rates of malignancy. It has long been recognized that widowed and divorced people die from much higher rates of all major causes of death including cancer. It is also clear that depression of immune system function predisposes to cancer, as vividly illustrated by a number of AIDS-related malignancies, including Kaposi's sarcoma.
Over the past two decades, several studies have shown that following the loss of a spouse there is a rapid and impressive decrease in immune system defenses, and possibly, this aberrant adaptive response is a mechanism that may explain some stress-related malignancies.
There is also evidence that increased stresses associated with the progress of civilization, contribute to cancer. I am not referring here to such things as smoking, air pollution, asbestos, radiation risks, and other carcinogenic issues, but rather to psychosocial stresses that became evident long before these problems associated with progress arrived. This concept is not new, and was proposed in Tanchou's "Memoir on the frequency of cancer" delivered to the French Academy of Sciences more than one hundred and sixty years ago. Tanchou noted that "cancer like madness increases in direct proportion to the civilization of the country." He noted that in Paris, the annual cancer death rate over an eleven-year period was 0.80 per thousand. Although only 0.2 per thousand was in London. So he proudly concluded that the data "showed that Paris is four times more civilized than London's". Powell in "The Pathology of Cancer"(1908), stated, "There can be no doubt that the various influences grouped under the heading of civilization play a part in producing a tendency to cancer." Similarly, Roberts wrote in malignancy and Evolution (1926), "I am of the general opinion that, whatever its origin, cancer is to a large extent a disease of civilization."
The renowned medical missionary, Dr. Albert Schweizer, wrote"upon my arrival in Gabon in 1913, I was astonished to discover that there were no cases of cancer.", over the years, cases began to appear in increasing numbers, and the conclusion of "my observations lean that I attribute to the fact that the natives are living more and more in the manner of the whites.".
The noted anthropologist and Arctic explorer, Vilhjalmur Stefansson, in his book, which is actually titled "Cancer: Disease of Civilization," noted the absence of cancer in the Eskimos upon their arrival in the Arctic, but a subsequent increase in the incidence of the disease when closer contact was established with white civilization. He cited Sir Robert McCarrison, a physician who had studied 11,000 Hunza natives in Kashmir from 1,904 to 1,911. Cancer was unknown, and these individuals seemed to preserve their youthful physique and appearance well into their sixties and seventies, and enjoyed unusual longevity. McCarrison attributes this to the fact that they were "far removed from the refinement of civilization ..... and endowed with a nervous system of remarkable stability." Both Stefansson and Schweitzer believed that this fact had nothing to do with diet, but to the stresses associated with the progress of civilization.
In July 1927, in an article on cancer, Dr. William Howard Hay noted:"A study of the distribution of cancer, among the races of the whole earth, shows a proportional relation between the incidence of cancer and the level of civilization; so that evidently something inherent in the customs of civilization is responsible for the difference in the incidence of cancer as compared with the uncivilized races and tribes. Climate has nothing to do with this difference, as evidenced by the fact that naturally living tribes will show a complete absence of this disease until they mix with more civilized societies, the first cases of cancer begin to peep through."
One of the most compelling arguments is found in Dr. Alexander Berglas' work on cancer: "Its Nature, Cause and Cure" (1957). Throughout this book the theme is set forth that cancer is a disease from which primitive peoples are partially or totally exempt, and that we are "threatened with death by cancer because of our inability to adapt to the present conditions of life.
Over the years, cancer research has become the domain of specialists in various fields. Despite the contributions of scientists, we are still far away from our goal, a cure for cancer.
This specialized work and knowledge gained through the study of independent parts has become an obstacle to reaching the whole. More than thirty years in the field of cancer research have convinced me that it is not to our advantage to continue down the path of detailed analysis. I have come to the conclusion that cancer may perhaps be just another intelligible natural process whose cause lies in our environment and our way of life."
In the U.S. we have found a disconcerting increase in the incidence of breast cancer in middle-aged women. The experts have no explanation, but I think this may also be related to the stress of "civilization". It has been well established that the younger a woman is when she has her first child or even when she becomes pregnant, the less likely she is to develop breast cancer. Pregnancy reduces prolactin, a pituitary hormone that stimulates breast tissue growth and promotes breast cancer in experimental animals. As more and more women enter the workforce they tend to remain single, or to marry but choose not to have children, or to do so only when they are much older. Since 1970 the percentage of women having their first child after age 35 has increased fivefold. Similarly, career-oriented women, especially those who do not have children, have a much higher incidence of fatal ovarian cancer. Single working women have fourteen times the risk of ovarian cancer than the reference group of housewives. The stress of the job itself may be a factor. Many married women have to juggle the responsibilities of work and housework. In addition, they often find that despite having equal or superior training, more experience and ability, they are paid less than their male counterparts, and usually hit a dead end when trying to reach the upper rungs of the corporate ladder.
Other demographic groups ranging from children, teenagers and the elderly are also experiencing stresses not experienced by previous generations as a result of the changes imposed by the pressures of contemporary civilization. We can speculate as to whether this may also have some bearing on an increase in certain malignant diseases.
Dr Paul J. Rosch, M.D., F.A.C.P.
br /> President, American Institute of Stress. Clinical Professor, New York University of Medicine and Psychiatry
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