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Common Questions

How does chemotherapy cancer treatment work?

Chemotherapy drugs kill rapidly dividing cells in a variety of ways depending on how the cancer grows, the types of cells it affects, and the stage it has reached. Some drugs work by damaging the cells' DNA. Others prevent cells from dividing. Still others disrupt cell metabolism or other functions.

What kind of chemotherapy will I have?

Your chemotherapy treatment will be decided upon based on numerous considerations, including:

  • Your diagnosis
  • The stage of your cancer
  • The expected behavior of the cancer
  • Where the cancer originated
  • Your age
  • Other medical problems you may have
  • Potential side effects

How is chemotherapy given?

Chemotherapy can be given in several ways, from a pill or an IV line to an injection into a vein or directly into the spinal fluid. Some kinds of chemotherapy are administered at a hospital or outpatient facility, while others can be given at home. For patients undergoing IV treatment, your doctor may recommend implanting a venous access device (VAD) to make it easier for both the patient and doctor to deliver the medicine at each appointment.

How often will I have chemotherapy treatments?

A course of chemotherapy usually comprises several cycles of treatment and rest. Your specific schedule will depend on the type of cancer and the drug combination being used. An individual treatment session may take a few minutes or a few hours. The treatment cycle may last anywhere from one day to one month or more, with treatments given daily or weekly. There are usually four to six treatment cycles.

Why do side effects arise, and how can they affect treatment?

Side effects arise because chemotherapy drugs cannot differentiate between cancer cells and rapidly dividing healthy cells. The drugs often attack normal tissues or organs, causing inconvenience, discomfort and even death. Side effects may be temporary or chronic, mild or life-threatening. If side effects prevent the administration of chemotherapy on schedule at the proper dosage, they can reduce the effectiveness of the treatment.

What side effects can I expect?

The most common side effects of chemotherapy are low blood counts (anemia), nausea, vomiting, hair loss and fatigue. Low white blood cell count (neutropenia) is one of the most serious potential side effects of chemotherapy. It can lead to severe infections or treatment interruptions.

Your doctor will discuss with you the side effects you might expect from your particular course of chemotherapy.

Will I feel sick?

Most patients will experience some degree of nausea and vomiting after a chemotherapy treatment. Anti-nausea/anti-emetic medications during or after a treatment session can help.

Will I lose my hair?

Many chemotherapy drugs cause temporary hair loss. Depending on the type and dosage of the drug, this can be anywhere from a slight thinning to complete baldness that affects not only the scalp but also the eyebrows, eyelashes, armpits, legs and pubic area. Hair loss typically begins about two to three weeks after the start of treatment and reverses about two to three weeks after treatment is completed. The hair that regrows may be a different color or texture than before.

Many patients prepare for hair loss by cutting the hair, purchasing a wig, or trying hats and scarves before treatment starts. Insurance may cover the cost of a hairpiece. During chemotherapy, patients should protect the scalp with sunblock. As hair begins to grow back, it is important to avoid strong chemicals, bleach or coloring agents.

What tests will be performed?

The specific tests you need will be determined by your doctor. In general, blood tests are done on the day of treatment or up to a week beforehand. These include a complete blood count (CBC), chemistry profile and any necessary cancer markers. The CBC is repeated one to two weeks after treatment.

Monitoring the CBC is important because chemotherapy drugs often attack red blood cells, white blood cells and platelets since these cells divide rapidly like cancer cells. Tracking red blood cell (RBC), white blood cell (WBC), or platelet (PLT) counts helps your doctor assess how toxic the chemotherapy is to your body, estimate your risk of complications, and plan your therapy in the future.

Symptoms of reduced blood counts should be reported to your doctor immediately. These include:

  • Temperature of over 100.5º F
  • Congestion or a cold
  • Rash or blisters
  • Easily bruised skin
  • Signs of bleeding
  • Infected cut
  • Itching or burning in the genital area
  • Weakness, fatigue, or shortness of breath

What is a bone marrow biopsy and aspiration?

Bone marrow is spongy tissue found inside some of your large bones, such as your pelvis. They contain stem cells that turn into white blood cells, red blood cells and platelets.  A biopsy is the insertion of a needle to remove a small piece of tissue and blood from the bone marrow.

A bone marrow examination offers detailed information about the condition of your blood cells. Your bone marrow is the central place of where blood cells are formed, so an examination gives detailed information of the types, amount and condition of your blood cells. It specifically can be studied for the presence of:

  • diseases involving the formation of blood cells
  • cancer cells
  • chromosome irregularitie
  • iron storage
  • monitor the effects of therapy such as chemo

How do I prepare for the procedure?

There is no preparation needed, as there are no restrictions. Take your usual medications. You may eat before the test

If you have an allergy to Lidocaine, let your Physician or Nurse Practitioner know

What can I expect during the procedure?

The bone marrow exam typically takes about 15-20 minutes

You will need to lie on your stomach, as the sample will be taken from your pelvis bone

Your Physician or Nurse Practitioner will talk to you throughout the procedure

When the Lidocaine is injected, you will feel a stinging sensation, then numbness to the area

A biopsy needle will then be inserted into the bone marrow, and a syringe will be used to remove the liquid portion from the bone marrow. This will cause a sharp, brief pain sensation that will quickly pass

A biopsy of the bone marrow will then be taken

After the needle is removed, pressure will be applied for 5-10 minutes or until bleeding stops

What can I expect after the procedure?

  • You may resume normal activity
  • Keep the pressure bandage on for at least 24 hours
  • Do not get the dressing wet for 24 hours, which means no showering or bathing
  • A small amount of bleeding is normal
  • Avoid heavy lifting or exercise for the next 24 hours
  • You may remove the dressing the next day
  • You may take Tylenol for the soreness

Call the office for any swelling at the biopsy site, development of fever >100.4 F, increasing redness or drainage at the biopsy site, or worsening pain or discomfort  

Are there risk with a bone marrow biopsy?

Risks associated Bone marrow exams do not usually pose any big risks. Complications are rare, however, as with any procedure; risks do exist that you should be aware of

Excessive bleeding, especially in those with a low platelet count or on a blood thinner

  • Breaking of needles within the bone, causing infection or bleeding
  •  Infection, especially in those with compromised immune systems
  • Long lasting pain to biopsy site

What other treatments might I receive?

Chemotherapy may be combined with radiation therapy, surgery, targeted therapy, complementary procedures or other treatment modalities. It is commonly recommended to shrink a tumor before operating on it ("neoadjuvant chemotherapy"), or to ensure that all cancer cells have been eradicated after surgery ("adjuvant chemotherapy").

What are colony stimulating factors?

Cancer treatments can compromise your immune system. This is because chemotherapy, which targets and destroys fast-growing cancerous cells, also kills healthy cells. White blood cells (WBCs), which are made in your bone marrow, are responsible for fighting infections by initiating an immune response. Because they are also fast growing, WBCs may also be affected by chemotherapy.

If the number of WBC's falls to low levels, your chance of getting an infection increases. We prescribe a synthetic form of a colony-stimulating factor (CSF) to help your body make more WBC's, which in turn can help your immune system recover. A CSF is a type of protein, known as growth factors that stimulate your bone marrow to increase the number and function of your WBC's. This affects important aspects of your immune system that can enhance your recovery. Your physician or nurse practitioner will determine when you should start and stop treatment. It is generally administered as a subcutaneous injection to the fatty party of your arm.

Some patients may experience side effects, most of which are mild to moderate. Some common side effects include bone pain, slight temperature elevations (usually less than 100.5 F) for a short period of time after the injection; and swelling, redness and/or discomfort at the injection site. These are normal and reduce over time as your body gets used to the medication.

Side effects can be reduced by taking Tylenol/Motrin and Benadryl half an hour to an hour prior to the injection, then applying ice to the site one minute before the injection. Avoid rubbing the skin before or after injection. You may also apply ice after the injection.

Some serious but rare side effects or symptoms may occur. Call you physician immediately if you have the following side effects:

Signs of infection, which can include chills, sore throat, congestion, inflammation (warmth or redness) of an area of the body, or development of a fever, especially if the fever is greater than 100.5 F and continues over 24 hrs.

Have trouble breathing or experience wheezing, fainting, skin rash, hives, or feel you are having an allergic reaction of any kind.

Experience sudden weight gain or other signs of fluid build-up such as swollen legs or feet and shortness of breath.

Develop chest pain, chest discomfort, or a rapid or irregular pulse.

Develop any other unexpected symptoms, or unusual side effects.

What is a prognosis?

People facing cancer are naturally concerned about what the future holds. A prognosis gives an idea of the likely course and outcome of a disease—that is, the chance that a patient will recover or have a recurrence (return of the cancer).

What factors affect a patient’s prognosis?

Many factors affect a person’s prognosis. Some of the most important are the type and location of the cancer, the stage of the disease (the extent to which the cancer has metastasized or spread), and its grade (how abnormal the cancer cells look and how quickly the cancer is likely to grow and spread). In addition, for hematologic cancers (cancers of the blodd or bone marrow) such as leukemias and lymphomas, the presence of chromosomal abnormalities and abnormalities in the patient’s complete blood count (CBC) can affect a person’s prognosis. Other factors that may also affect the prognosis include the person’s age, general health, and response to treatment.

How do statistics contribute to predicting a patient’s prognosis?

When doctors discuss a person’s prognosis, they carefully consider all factors that could affect that person’s disease and treatment and then try to predict what might happen. The doctor bases the prognosis on information researchers have collected over many years about hundreds or even thousands of people with cancer.

When possible, the doctor uses statistics based on groups of people whose situations are most similar to that of an individual patient. Several types of statistics might be used to discuss prognosis. Some commonly used statistics are described below:

  • Survival rate indicates the percentage of people with a certain type and stage of cancer who survive for a specific period of time after their diagnosis. For example, 55 out of 100 people with a certain type of cancer will live for at least 5 years, and the other 45 people will not. Survival statistics may further categorize the people who die by cause of death because some will die from unrelated causes. For example, of the 45 people mentioned above, 35 may die from their cancer and 10 may die from other causes.
  • The 5-year survival rate indicates the percentage of people who are alive 5 years after their cancer diagnosis, whether they have few or no signs or symptoms of cancer, are free of disease, or are having treatment. Five-year survival rates are used as a standard way of discussing prognosis as well as a way to compare the value of one treatment with another. It does not mean that a patient can expect to live for only 5 years after treatment or that there are no cures for cancer.
  • Disease-free or recurrence-free survival rates represent how long one survives free of the disease, rather than until death.

Because survival rates are based on large groups of people, they cannot be used to predict what will happen to a particular patient. No two patients are exactly alike, and treatment and responses to treatment vary greatly.

The doctor may speak of a favorable prognosis if the cancer is likely to respond well to treatment. The prognosis may be unfavorable if the cancer is likely to be difficult to control. It is important to keep in mind, however, that a prognosis is only a prediction. Again, doctors cannot be absolutely certain about the outcome for a particular patient.

Is it helpful to know the prognosis?

Cancer patients and their loved ones face many unknowns. Understanding cancer and what to expect can help patients and their loved ones plan treatment, think about lifestyle changes, and make decisions about their quality of life and finances. Many people with cancer want to know their prognosis. They find it easier to cope when they know the statistics. They may ask their doctor or search for statistics such as survival rates on their own. Other people find statistical information confusing and frightening, and they think it is too impersonal to be of use to them.

The doctor who is most familiar with a patient’s situation is in the best position to discuss the prognosis and to explain what the statistics may mean for that person. At the same time, it is important to understand that even the doctor cannot tell exactly what to expect. In fact, a person’s prognosis may change if the cancer progresses or if treatment is successful.

Seeking information about the prognosis is a personal decision. It is up to each patient to decide how much information he or she wants and how to deal with it.

What is the prognosis if a patient decides not to have treatment?

Because everyone’s situation is different, this question can be difficult to answer.  Prognostic statistics often come from studies comparing new treatments with best available treatments, not with “no treatment.” Therefore, it is not always easy for doctors to accurately estimate prognosis for patients who decide not to have treatment. However, as mentioned above, the doctor who is most familiar with a patient’s situation is in the best position to discuss prognosis, taking into account individual characteristics of the patient that can affect the overall situation.

There are many reasons patients decide not to have treatment. One reason may be concern about side effects related to treatment. Patients should discuss this concern with their doctor. Many medications are available to prevent or control the side effects caused by cancer therapies. Another reason patients might decide not to have treatment is that their type of cancer does not have a good prognosis even when treated. In these cases, patients may want to explore clinical trials (research studies). A clinical trial may offer access to new drugs that may be more promising than the standard treatments available.

Obesity and Cancer: Questions and Answers

What is obesity?

People who are obese have an abnormally high and unhealthy proportion of body fat. To measure obesity, researchers commonly use a formula based on weight and height known as the body mass index (BMI). BMI is the ratio of weight (in kilograms) to height (in meters) squared. BMI provides a more accurate measure of obesity or being overweight than does weight alone.

<18.5 :  underweight

18.5 to 24.9: healthy

25.0 to 29.9: overweight

>30.0: obese

Compared with people in the healthy weight category, those who are overweight or obese are at greater risk for many diseases, including diabetes, high blood pressure, cardiovascular diseases, stroke, and certain cancers. Obesity lowers life expectancy.

  1. How common is overweight or obesity?

    Results from the 1999–2000 National Health and Nutrition Examination Survey (NHANES) show that an estimated 64 percent of U.S. adults are either overweight or obese. This represents an increase of 8 percentage points compared with the estimates from an earlier survey (NHANES III 1988–1994).

    Nearly one-third of all adults are now classified as obese. This reflects an increase of 7.6 percentage points since 1994. The data show that 31 percent of adults age 20 and older—nearly 59 million people—have a body mass index (BMI) of 30 or greater, compared with 23 percent in 1994.

    In addition, the percentage of children who are overweight continues to increase. Among children and teens ages 6 to 19, 15 percent (almost 9 million) are overweight according to the 1999–2000 data, or triple what the proportion was in 1980.

  2. What causes obesity?

    Experts have concluded that the chief causes of obesity are a sedentary lifestyle and overconsumption of high-calorie food:

    • Sedentary lifestyle—Researchers have found a strong correlation between lack of physical activity and obesity.

    • Diet—A diet high in calories and/or fat appears to be an important factor in obesity.

  3. What have scientists learned about the relationship between obesity and cancer?

    In 2001, experts concluded that cancers of the colon, breast (postmenopausal), endometrium (the lining of the uterus), kidney, and esophagus are associated with obesity. Some studies have also reported links between obesity and cancers of the gallbladder, ovaries, and pancreas.

    Obesity and physical inactivity may account for 25 to 30 percent of several major cancers—colon, breast (postmenopausal), endometrial, kidney, and cancer of the esophagus.

    Preventing weight gain can reduce the risk of many cancers. Experts recommend that people establish habits of healthy eating and physical activity early in life to prevent overweight and obesity. Those who are already overweight or obese are advised to avoid additional weight gain, and to lose weight through a low-calorie diet and exercise. Even a weight loss of only 5 to 10 percent of total weight can provide health benefits.

  4. How many people get cancer by being overweight or obese? How many die?

    In 2002, about 41,000 new cases of cancer in the United States were estimated to be due to obesity. This means that about 3.2 percent of all new cancers are linked to obesity.

    A recent report estimated that, in the United States, 14 percent of deaths from cancer in men and 20 percent of deaths in women were due to overweight and obesity.

  5. Does obesity increase the risk of breast cancer?

    The effect of obesity on breast cancer risk depends on a woman’s menopausal status. Beforemenopause, obese women have a lower risk of developing breast cancer than do women of a healthy weight. However, after menopause, obese women have 1.5 times the risk of women of a healthy weight.

    Obese women are also at increased risk of dying from breast cancer after menopause compared with lean women. Scientists estimate that about 11,000 to 18,000 deaths per year from breast cancer in U.S. women over age 50 might be avoided if women could maintain a BMI under 25 throughout their adult lives.

    Obesity seems to increase the risk of breast cancer only among postmenopausal women who do not use menopausal hormones. Among women who use menopausal hormones, there is no significant difference in breast cancer risk between obese women and women of a healthy weight.

    Both the increased risk of developing breast cancer and dying from it after menopause are believed to be due to increased levels of estrogen in obese women. Before menopause, the ovaries are the primary source of estrogen. However, estrogen is also produced in fat tissue and, after menopause, when the ovaries stop producing hormones, fat tissue becomes the most important estrogen source. Estrogen levels in postmenopausal women are 50 to 100 percent higher among heavy versus lean women. Estrogen-sensitive tissues are therefore exposed to more estrogen stimulation in heavy women, leading to a more rapid growth of estrogen-responsive breast tumors.

    Another factor related to the higher breast cancer death rates in obese women is that breast cancer is more likely to be detected at a later stage in obese women than in lean women. This is because the detection of a breast tumor is more difficult in obese versus lean women.

    Studies of obesity and breast cancer in minority women in the United States have been limited. There is some evidence that, among African American women, the risk associated with obesity may be absent or less than that of other populations. However, a recent report showed that African American women who have a high BMI are more likely to have an advanced stage of breast cancer at diagnosis. Another report showed that obese Hispanic white women were twice as likely to develop breast cancer as non-obese Hispanics, but the researchers did not detect a difference in risk for obese Hispanic women before and after menopause.

    Weight gain during adulthood has been found to be the most consistent and strongest predictor of breast cancer risk in studies in which it has been examined.

    The distribution of body fat may also affect breast cancer risk. Women with a large amount ofabdominal fat have a greater breast cancer risk than those whose fat is distributed over the hips, buttocks, and lower extremities. Results from studies on the effect of abdominal fat are much less consistent than studies on weight gain or BMI.

  6. Does obesity increase the risk of cancer of the uterus?

    Obesity has been consistently associated with uterine (endometrial) cancer. Obese women have two to four times greater risk of developing the disease than do women of a healthy weight, regardless of menopausal status. Increased risk has also been demonstrated among overweight women. Obesity has been estimated to account for about 40 percent of endometrial cancer cases in affluent societies.

    It is unclear why obesity is a risk factor for endometrial cancer; however, it has been suggested that lifetime exposure to hormones and high levels of estrogen and insulin in obese women may be contributing factors.

  7. Does obesity increase the risk of colon cancer?

    Colon cancer occurs more frequently in people who are obese than in those of a healthy weight. An increased risk of colon cancer has been consistently reported for men with high BMIs. The relationship between BMI and risk in women, however, has been found to be weaker or absent .

    Unlike for breast and endometrial cancer, estrogen appears to be protective for colon cancer for women overall. However, obesity and estrogen status also interact in influencing colon cancer risk. Women with a high BMI who are either premenopausal or postmenopausal and taking estrogens have an increased risk of colon cancer similar to that found for men with a high BMI. In contrast, women with a high BMI who are postmenopausal and not taking estrogens do not have an increased risk of colon cancer (41).

    There is some evidence that abdominal obesity may be more important in colon cancer risk. In men, a high BMI tends to be associated with abdominal fat. In women, fat is more likely to be distributed in the hips, thighs, and buttocks. Thus, two measures of abdominal fat, waist-to-hip ratio or waist circumference, may be better predictors of colon cancer risk. Few studies have yet compared waist-to-hip ratios to colon cancer risk in women, however. One study that did find an increased risk of colon cancer among women with high waist-to-hip ratios found that the association was present only among inactive women, suggesting that high levels of physical activity may counteract the effects of increased abdominal fat.

    A number of mechanisms have been proposed for the adverse effect of obesity on colon cancer risk. One of the major hypotheses is that high levels of insulin or insulin-related growth factors in obese people may promote tumor development.

  8. Does obesity increase the risk of kidney cancer?

    Studies have consistently found a link between a type of kidney cancer (renal cell carcinoma) and obesity in women, with some studies finding risk among obese women to be two to four times the risk of women of a healthy weight.

    Results of studies including men have been more variable, ranging from an association similar to that seen in women, to a weak association, to no association at all. A meta-analysis (where several studies are combined into a single report), which found an equal association of risk among men and women, estimated the kidney cancer risk to be 36 percent higher for an overweight person and 84 percent higher for an obese person compared to those with a healthy weight.

    The mechanisms by which obesity may increase renal cell cancer risk are not well understood. An increased exposure to sex steroids, estrogen and androgen, is one possible mechanism.

  9. Does obesity increase the risk of cancer of the esophagus or stomach?

    Overweight and obese individuals are two times more likely than healthy weight people to develop a type of esophageal cancer called esophageal adenocarcinoma. A smaller increase in risk has been found for gastric cardia cancer, a type of stomach cancer that begins in the area of the stomach next to the esophagus. Most studies have not observed increases in risk with obesity in another type of esophageal cancer, squamous cellcancer. An increased risk of esophageal adenocarcinoma has also been associated with weight gain, smoking, and being younger than age 59.

    The mechanisms by which obesity increases risk of adenocarcinoma of the esophagus and gastric cardia are not well understood. One of the leading mechanisms proposed has been that increases in gastric reflux due to obesity may increase risk. However, in the few studies that have examined this issue, risk associated with BMI was similar for those with and without gastric reflux.

  10. Does obesity increase the risk of prostate cancer?

    Of the more than 35 studies on prostate cancer risk, most conclude that there is no association with obesity. Some report that obese men are at higher risk than men of healthy weight, particularly for more aggressive tumors. One study found an increased risk among men with high waist-to-hip ratios, suggesting that abdominal fat may be a more appropriate measure of body size in relation to prostate cancer.

    Studies examining BMI and prostate cancer mortality have had conflicting results.

    Despite the lack of association between obesity and prostate cancer incidence, a number of studies have examined potential biological factors that are related to obesity, such as insulin-related growth factors, leptin, and other hormones. Results of these studies are inconsistent, but generally, risk has been linked to men with higher levels of leptin, insulin, and IGF–1 (insulin-like growth factor-1).

  11. Is there any evidence that obesity is linked to cancer of the gallbladder, ovaries, or pancreas?

    An increased risk of gallbladder cancer has been found to be associated with obesity, particularly among women. This may be due to the higher frequency of gallstones in obese individuals, as gallstones are considered a strong risk factor for gallbladder cancer. However, there is not enough evidence to draw firm conclusions.

    It is unclear whether obesity affects ovarian cancer risk. Some studies report an increased risk among obese women, whereas others have found no association. A recent report found an increased risk in women who were overweight or obese in adolescence or young adulthood; no increased risk was found in older obese women.

    Studies evaluating the relationship between obesity and pancreatic cancer have been inconsistent. One recent study found that obesity increases the risk of pancreatic cancer only among those who are not physically active. A recent meta-analysis reported that obese people may have a 19 percent higher risk of pancreatic cancer than those with a healthy BMI. The results, however, were not conclusive.

  12. Does avoiding weight gain decrease the risk of cancer?

    The most conclusive way to test if avoiding weight gain will decrease the risk of cancer is through a controlled clinical trial. At present, there have been no controlled clinical trials on the effect on cancer related to avoiding weight gain. However, many observational studies have shown that avoiding weight gain lowers the risk of cancers of the colon, breast (postmenopausal), endometrium, kidney, and esophagus. There is limited evidence for thyroid cancers, and no substantial evidence for all other cancers.

  13. Does losing weight lower the risk of cancer?

    There is insufficient evidence that intentional weight loss will affect cancer risk for any cancer. A very limited number of observational studies have examined the effect of weight loss, and a few found some decreased risk for breast cancer among women who have lost weight. However, most of these studies have not been able to evaluate whether the weight loss was intentional or related to other health problems.

    One recent study that examined the effect of intentional weight loss found that women who experienced intentional weight loss of 20 or more pounds and were not currently overweight had cancer rates at the level of healthy women who never lost weight. However, unintentional weight loss episodes were not associated with decreased cancer risk.

  14. Does regular physical activity lower the risk of cancer?

    There have been no controlled clinical trials on the effect of regular physical activity on the risk of developing cancer. However, observational studies have examined the possible association between physical activity and a lower risk of developing colon or breast cancer:

    • Colon cancer: In 2002, a major review of observational trials found that physical activity reduced colon cancer risk by 50 percent. This risk reduction occurred even with moderate levels of physical activity. For example, one study showed that even moderate exercise, such as brisk walking for 3 to 4 hours per week, can lower colon cancer risk.

      A limited number of studies have examined the effect of physical activity on colon cancer risk for both lean and obese people. Most of these studies have found a protective effect of physical activity across all levels of BMI.

    • Breast cancer: The pattern of the association between physical activity and breast cancer risk is somewhat different. Most studies on breast cancer have focused on postmenopausal women. A recent study from the Women’s Health Initiative found that physical activity among postmenopausal women at a level of walking about 30 minutes per day was associated with a 20 percent reduction in breast cancer risk. However, this reduction in risk was greatest among women who were of normal weight. For these women, physical activity was associated with a 37 percent decrease in risk. The protective effect of physical activity was not found among overweight or obese women.
Psychological Stress and Cancer: Questions and Answers
The complex relationship between physical and psychological health is not well understood. Scientists know that psychological stress can affect the immune system, the body’s defense against infection and disease (including cancer); however, it is not yet known whether stress increases a person’s susceptibility to disease..

What is psychological stress?

Psychological stress refers to the emotional and physiological reactions experienced when an individual confronts a situation in which the demands go beyond their coping resources. Examples of stressful situations are marital problems, death of a loved one, abuse, health problems, and financial crises.

How does stress affect the body?

The body responds to stress by releasing stress hormones, such as epinephrine (also called adrenaline) and cortisol (also called hydrocortisone). The body produces these stress hormones to help a person react to a situation with more speed and strength. Stress hormones increase blood pressure, heart rate, and blood sugar levels. Small amounts of stress are believed to be beneficial, but chronic (persisting or progressing over a long period of time) high levels of stress are thought to be harmful.
Stress that is chronic can increase the risk of obesity, heart disease, depression, and various other illnesses. Stress also can lead to unhealthy behaviors, such as overeating, smoking, or abusing drugs or alcohol, that may affect cancer risk.

Can stress increase a person’s risk of developing cancer?

Studies done over the past 30 years that examined the relationship between psychological factors, including stress, and cancer risk have produced conflicting results. Although the results of some studies have indicated a link between various psychological factors and an increased risk of developing cancer, a direct cause-and-effect relationship has not been proven.
Some studies have indicated an indirect relationship between stress and certain types of virus-related tumors. Evidence from both animal and human studies suggests that chronic stress weakens a person’s immune system, which in turn may affect the incidence of virus-associated cancers, such as Kaposi sarcoma and some lymphomas.
More recent research with animal models (animals with a disease that is similar to or the same as a disease in humans) suggests that the body’s neuroendocrine response (release of hormones into the blood in response to stimulation of the nervous system) can directly alter important processes in cells that help protect against the formation of cancer, such as DNA repair and the regulation of cell growth.

Why are the study results inconsistent?

It is difficult to separate stress from other physical or emotional factors when examining cancer risk. For example, certain behaviors, such as smoking and using alcohol, and biologicalfactors, such as growing older, becoming overweight, and having a family history of cancer, are common risk factors for cancer. Researchers may have difficulty controlling the presence of these factors in the study group or separating the effects of stress from the effects of these other factors.  In some cases, the number of people in the study, length of follow-up, or analysis used is insufficient to rule out the role of chance.  Also, studies may not always take into account that cancer is not a homogeneous (uniform in nature) disease.

How does stress affect people who have cancer?

Studies have indicated that stress can affect tumor growth and spread, but the precise biological mechanisms underlying these effects are not well understood. Scientists have suggested that the effects of stress on the immune system may in turn affect the growth of some tumors. However, recent research using animal models indicates that the body’s release of stress hormones can affect cancer cell functions directly.
A review of studies that evaluated psychological factors and outcome in cancer patients suggests an association between certain psychological factors, such as feeling helpless or suppressing negative emotions, and the growth or spread of cancer, although this relationship was not consistently seen in all studies.. In general, stronger relationships have been found between psychological factors and cancer growth and spread than between psychological factors and cancer development.
Screening and Testing to Detect Cancer

What Is Cancer Screening?

Some types of cancer can be found before they cause symptoms. Checking for cancer (or for conditions that may lead to cancer) in people who have no symptoms is called screening. Screening can help doctors find and treat some types of cancer early. Generally, cancer treatment is more effective when the disease is found early. However, not all types of cancer have screening tests and some tests are only for people with specific genetic risks.

Overview of Cancer Screening and Testing

Types of Screening Tests

Screening for Specific Types of Cancer

For some types of cancer, research shows that using certain screening tests regularly will reduce deaths from that cancer.

For other types of cancer, screening methods are in use or being studied, but their ability to reduce the number of deaths from cancer has not been established.


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101 E. Beverly Blvd.
Suite 200
Montebello, CA 90640

Tel. 323.278.4400
Fax 323.278.4401
1360 W. 6th Street
Suite G
San Pedro, CA 90732

Tel. 310.547.2445
Fax 310.547.2610
1970 Old Tustin Ave.
Suite A
Santa Ana, CA 92705

Tel. 714.542.0102
Fax 714.479.0709
4305 Torrance Blvd.
Suite 109
Torrance, CA 90503

Tel. 310.935.4525
Fax 310.755.6317
591 N. 13th Ave.
Suite 5
Upland, CA 91786

Tel. 909.906.1519
Fax 909.256.8976
1135 S. Sunset Ave.
Suite 301
West Covina, CA 91790

Tel. 626.283.5183
Fax 626.214.1547
8135 S. Painter Ave.
Suite 103
Whittier, CA 90602

Tel. 562.698.6888
Fax 562.698.5255