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Stress has long been associated with cancer development and incidence, yet epidemiologic studies and clinical trials report conflicting findings. This review summarizes stress effects and mechanisms in cancer, highlighting molecular, cellular, and endocrine pathways from animal models and detailing indirect microenvironment/immune dysregulation and direct neuroendocrine signaling.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/role-of-stress-in-the-pathogenesis-of-cancer-review/380481/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/role-of-stress-in-the-pathogenesis-of-cancer-review/380481.png","ImageObject",300,407,{"name":92,"@type":93},"Adam","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-08","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":19},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"How is stress defined in relation to cancer pathogenesis in this review?","Question",{"text":112,"@type":113},"Stress is described as a state of disrupted homeostasis triggered by intrinsic or extrinsic stressors. It is counteracted by physiological and behavioral adaptive responses that connect to cancer development and progression.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Why do epidemiological studies and clinical trials show contradictory results about stress and cancer?",{"text":117,"@type":113},"The review notes that, despite decades of reported associations, epidemiological studies and clinical trials have produced contradictory findings. It discusses underlying mechanisms to contextualize these inconsistent outcomes.",{"name":119,"@type":110,"acceptedAnswer":120},"What mechanisms link stress to cancer progression?",{"text":121,"@type":113},"Mechanisms include indirect effects through changes in the cancer microenvironment or immune system dysregulation, and direct effects through neuroendocrine stress-related signaling molecules binding to cancer cell receptors.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},380481,1790590055,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":19,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},1374404737137,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","INTERNATIONAL JOURNAL OF ONCOLOGY 63: 124, 2023  \nRole of stress in the pathogenesis of cancer (Review)  \nIOANNIS G. LEMPESIS 1,2* , VASILIKI EPAMEINONDAS GEORGAKOPOULOU 1,2* , PETROS PAPALEXIS3,4 , GEORGIOS P. CHROUSOS5,6 and DEMETRIOSA. SPANDIDOS7  \n1Department of Infectious Diseases‑COVID‑19 Unit, and 2Department of Pathophysiology, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens; 3Unit of Endocrinology, First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens; 4Department of Biomedical Sciences, University of West Attica, 12243 Athens; 5Clinical, Translational and Experimental Surgery Research Centre, Biomedical Research Foundation Academy of Athens; 6University Research Institute of Maternal and Child Health and Precision Medicine and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, 11527 Athens; 7Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece  \nReceived July 24, 2023; Accepted September 1, 2023  \nDOI: 10.3892/ijo.2023.5572  \nAbstract. Stress is a state of disrupted homeostasis, triggered by intrinsic or extrinsic factors, the stressors, which are coun‑ teracted by various physiological and behavioural adaptive responses. Stress has been linked to cancer development and incidence for decades; however, epidemiological studies and clinical trials have yielded contradictory results. The present review discusses the effects of stress on cancer development and the various underlying mechanisms. Animal studies have revealed a clear link between stress and cancer progression, revealing molecular, cellular and endocrine processes that are implicated in these effects. Thus, stress hormones, their receptor systems and their intracellular molecular pathways mediate the effects of stress on cancer initiation, progression and the development of metastases. The mechanisms linking stress and cancer progression can either be indirect, mediated by changes in the cancer microenvironment or immune system dysregulation, or direct, through the binding of neuroendocrine stress‑related signalling molecules to cancer cell receptors. Stress affects numerous anti‑ and pro‑cancer immune system components, including host resistance to metastasis, tumour retention and/or immune suppression. Chronic psychological stress through the elevation of catecholamine levels may increase cancer cell death resistance. On the whole, stress is linked to cancer development and incidence, with psychological  \nCorrespondence to: Dr Vasiliki Epameinondas Georgakopoulou, Department of Infectious Diseases‑COVID‑19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 17 Agiou Thoma Street, 11527 Athens, Greece  \nE‑mail: [vaso_georgakopoulou@hotmail.com](vaso_georgakopoulou@hotmail.com)  \n*Contributed equally  \nKey words: cancer, stress, pathogenesis, hormones, pathophysiology  \nstressors playing a crucial role. Animal studies have revealed a better link than human ones, with stress‑related hormones influencing tumour development, migration, invasion and cell proliferation . Randomized controlled trials are required to further evaluate the long‑term cancer outcomes of stress and its management.  \nContents  \n1. Introduction  \n2. Epidemiological observations  \n3. Physiological stress responses  \n4. Cancer hallmarks and the determination of the phases of oncogenesis  \n5. Pathological mechanisms of the effects of stress on cancer  \n6. Conclusions and future perspectives  \n1. Introduction  \nStress can be defined as a state of disrupted homeostasis triggered by intrinsic or extrinsic stressors, which is counter‑ acted by a plethora of physiological and behavioural adaptive responses aiming to re‑establish the altered equilibrium of the organism (1‑3) . The concept of a corporal ‘steady state’that","cbCaiqlhbDpbEzTO","https://ap.wps.com/l/cbCaiqlhbDpbEzTO","pdf",675263,14,"English","# Abstract\n# Introduction\n# Epidemiological observations\n# Physiological stress responses\n# Cancer hallmarks and determination of the phases of oncogenesis\n# Pathological mechanisms of the effects of stress on cancer\n# Conclusions and future perspectives","[{\"question\":\"How is stress defined in relation to cancer pathogenesis in this review?\",\"answer\":\"Stress is described as a state of disrupted homeostasis triggered by intrinsic or extrinsic stressors. It is counteracted by physiological and behavioral adaptive responses that connect to cancer development and progression.\"},{\"question\":\"Why do epidemiological studies and clinical trials show contradictory results about stress and cancer?\",\"answer\":\"The review notes that, despite decades of reported associations, epidemiological studies and clinical trials have produced contradictory findings. It discusses underlying mechanisms to contextualize these inconsistent outcomes.\"},{\"question\":\"What mechanisms link stress to cancer progression?\",\"answer\":\"Mechanisms include indirect effects through changes in the cancer microenvironment or immune system dysregulation, and direct effects through neuroendocrine stress-related signaling molecules binding to cancer cell receptors.\"}]","Role of stress in the pathogenesis of cancer - Review | PDF",1790240374,35]