Chronic stress in solid tumor development: from mechanisms to interventions

• Published in: Journal of biomedical science Vol. 30; no. 1; p. 8
• Main Authors: Yan, Jiajing, Chen, Yibing, Luo, Minhua, Hu, Xinyu, Li, Hongsheng, Liu, Quentin, Zou, Zhengzhi
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 28-01-2023; BioMed Central; BMC
• Subjects: Angiogenesis; Apoptosis; Breast cancer; Cancer; Cancer therapies; Cancer treatment; Care and treatment; Catecholamines; Cell cycle; Chemokines; Chemotherapy; Chronic stress; Damage accumulation; Development and progression; Disease Progression; DNA damage; Dopamine; Extracellular matrix; Health aspects; Health services; Hormones; Hormones - pharmacology; Humans; Immunotherapy; Kinases; Medical prognosis; Mental disorders; Mental health; Metabolism; Metastases; Metastasis; Neoplasms - metabolism; Nervous system; Neuroendocrine system; Neuromodulation; Ovarian cancer; Patients; Pharmacology; Radiation therapy; Review; Signal Transduction; Solid tumors; Stem cells; Steroids; Stress; Tumor cells; Tumor development; Tumor Microenvironment; Tumors; Chronic stress; Tumor microenvironment; Cancer treatment; Tumor development
• ISSN: 1423-0127; 1021-7770; 1423-0127
• DOI: 10.1186/s12929-023-00903-9

Chronic stress results in disturbances of body hormones through the neuroendocrine system. Cancer patients often experience recurrent anxiety and restlessness during disease progression and treatment, which aggravates disease progression and hinders treatment effects. Recent studies have shown that chronic stress-regulated neuroendocrine systems secret hormones to activate many signaling pathways related to tumor development in tumor cells. The activated neuroendocrine system acts not only on tumor cells but also modulates the survival and metabolic changes of surrounding non-cancerous cells. Current clinical evidences also suggest that chronic stress affects the outcome of cancer treatment. However, in clinic, there is lack of effective treatment for chronic stress in cancer patients. In this review, we discuss the main mechanisms by which chronic stress regulates the tumor microenvironment, including functional regulation of tumor cells by stress hormones (stem cell-like properties, metastasis, angiogenesis, DNA damage accumulation, and apoptotic resistance), metabolic reprogramming and immune escape, and peritumor neuromodulation. Based on the current clinical treatment framework for cancer and chronic stress, we also summarize pharmacological and non-pharmacological therapeutic approaches to provide some directions for cancer therapy.