What contributes to stress?

Stress is our response to challenging situations in our lives. You may need to identify whether stress is a big actor in your life now. If you think stress is affecting your health and well-being, consider making Managing your stress response › a high priority in your integrative cancer care plan.

Common stressors among people with cancer and their caregivers

We recognize cancer introduces scenarios and environment that are stressful for many people with cancer and their caregivers:

  • The cancer diagnosis
  • Financial burdens from treatments, travel, and caregiving
  • Loss of income due to illness
  • Uncertainty regarding your job, medical insurance, housing, child care, and life logistics 
  • Schedule disruptions
  • Disruptions daily routines such eating, sleeping, school, and recreation
  • Changes in family member roles
  • Pain, anxiety, fatigue, grief, nausea and vomiting, and other symptoms related to the diagnosis and treatment
  • Feelings of isolation
  • Changes in physical appearance
  • Worry about suffering, dying, and loved ones
  • Bereavement after the death of a loved one

Other contributors to stress

  • Poor sleep quality
  • Caffeine
  • Stimulants such as ephedra, ginseng, and bitter orange can increase your stress response.


Can stress cause cancer?

CancerChoices Senior Clinical Consultant Laura Pole, RN, MSN, OCNS: People sometimes ask, “Did stress cause my cancer?” Stress alone did not cause your cancer. However, we know that the chemicals released in the stress response can speed up tumor growth. For instance, these stress-response chemicals can promote conditions such as insulin resistance, which change the tumor microenvironment and impact your body’s ability to stay healthy as you are going through treatment. We review the research in What does the evidence show? Your stress is not responsible for your cancer diagnosis. But mitigating your stress can help your body be as healthy as possible to give you the best outcome. 

Psychiatrist David Servan-Schreiber explains: “It usually takes anywhere from five to forty years for the ‘seed’ of cancer in the form of a cellular anomaly to become a detectable cancerous tumor … No psychological factor by itself has ever been identified as being capable of creating that cancer seed … However, certain reactions to psychological stress can profoundly influence the soil in which the seed develops… The factors contributing to cancer are so numerous and varied that no one should ever blame themselves or feel guilty for developing this disease … However, anyone who has been diagnosed with cancer has the opportunity to learn to live differently, with the likely benefit of aiding in recovery.”1Servan-Schreiber D. Anticancer: A New Way of Life. New York: Penguin Group. 2008.

Cancer as a predictor of distress

Among women with breast cancer, these situations are predictors of higher levels of distressemotional, social, spiritual, or physical pain or suffering that may cause a person to feel sad, afraid, depressed, anxious, or lonely; people in distress may also feel that they are not able to manage or cope with changes caused by normal life activities or by having a disease, such as cancer:2Syrowatka A, Motulsky A et al. Predictors of distress in female breast cancer survivors: a systematic review. Breast Cancer Research and Treatment. 2017 Sep;165(2):229-245. 

  • Advanced cancer at diagnosis
  • Treatment with chemotherapy
  • Longer primary treatment duration
  • Recent transition from active treatment to “cancer survivor”
  • Breast cancer recurrence 

Similar situations are likely predictors of distress and other symptoms among many people cancer, although we don’t have research specifically showing this yet.

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Laura Pole, MSN, RN, OCNS

Senior Clinical Consultant
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Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.

For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.

Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.

Laura Pole, MSN, RN, OCNS Senior Clinical Consultant

Nancy Hepp, MS

Lead Researcher
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Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher and writer for CancerChoices and also served as the first program manager. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.

Nancy Hepp, MS Lead Researcher

Last update: May 1, 2024

Last full literature review: November 2021

CancerChoices provides information about integrative in cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies and self-care lifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

Our staff have no financial conflicts of interest to declare. We receive no funds from any manufacturers or retailers gaining financial profit by promoting or discouraging therapies mentioned on this site.