Stress plays a significant role in cancer, impacting key cancer pathways, inhibiting important health processes and promoting invasion and metastasis. We know that stress and cancer feed off each other in a most unhealthy way, but the experience of cancer is so inherently stressful it’s difficult to see how to separate the two.
As a nutritional therapist I spend my life trying to ensure we have all the right nutrients in all the right places both to improve the way our bodies work, and to reduce the impact of diet and lifestyle choices on our health. But – no matter how controlled we manage to be – I have learned that our thoughts can scupper all that effort. I often say to my clients that ‘our thoughts are the worst things that ever happen to us’!
For most of us, the day of diagnosis will be top of the list of stressful life experiences. On a biochemical level your body will be pumping out cortisol, noradrenaline and adrenaline in response to fear; your happy neurotransmitters will be severely beaten up; your calming GABA molecules will have a hard time trying to stop your amygdala exploding with a sense of threat; and your blood stream will be flooded with dread as the news unfolds.
Diagnosis gives you membership to an exclusive club you never wanted to join. It comes with a set of beliefs about health, and assumes a lack of choice about treatment. The hard-working NHS provides a fantastic standard of care to ensure everyone is offered the same opportunities to beat the disease. The system is overworked, underpaid, and straining at the seams. It’s full of wonderful people but it fails in one important respect: they don’t encourage people to help themselves beyond what the state can afford – or imagine. If only, following diagnosis, someone were waiting in the next room to take us one step further: “you’ve had the bad news, now here’s the good news”. Imagine what a difference that would make, right from the start!
When I was diagnosed I was profoundly ignorant about cancer and my pervading thoughts were that this was the beginning of the end. When my surgeon explained the biopsy results with the words “I’m afraid we cannot hide this from you”, I knew it was bad. As I left the room I contemplated writing a letter for every one of my two-year old daughter’s birthdays, wondering what I would say to her from another world. Those were my darkest moments, as I longed to ‘unlearn’ what I had been told, and faced my own mortality, at ultra-high resolution, for the very first time. I longed for someone to tell me it would all be OK; someone to give me the hope of a happy ending.
The most profound way to combat the stress of cancer is to reject the narrative. Not with a sense of denial, but to realise that the people whose unhappy job it is to give you the news are working at the cancer coalface. They see people at their worst all the time, at diagnosis, during treatment, and if it comes back. They rarely see the success stories because they are nowhere near a hospital. Inevitably, it gives our oncology staff a certain perspective. For your own sanity and survival, you need a different one.
Recently, the New England Journal of Medicine reported that the side effects of statins were largely down to ‘nocebo’ effect – where patients expect to experience negative side effects, and so they do. It’s great to see the medical profession acknowledging the psychological impact of medicine. In the same vein, I would argue that nocebo effect kicks in strongly after cancer diagnosis, that the diagnosis itself, and the accompanying stress, is the cause of many of the health effects that we see.
I’m hugely cheered by the paradigm shift within the world of cancer. Our increased understanding of cancer metabolism and genetics is opening the way for new medical treatments, and the future has never looked better for newly diagnosed cancer patients. But as individuals we can, in my opinion, make an even bigger difference by changing our mindset. The recent Your Life and Cancer 2020 conference organised by Yes to Life was a giant leap for integrated oncology in the UK. Enlisting the support of complementary medicine practitioners as part of an integrated cancer strategy is a hugely hopeful thing to do. It’s my belief that the healing starts with the positive choice to help yourself, exerting a powerful placebo effect before you even start eating more broccoli!
Once you have stepped into a more enlightened space, then stress management happens at a different level of magnitude. This is not just about hope – powerful though that is – it’s about understanding the way our bodies work and realising that our mental health exerts a powerful effect on our physical health, even when we are tackling something as complex as cancer.
Another thing I’ve learned from my clinical practice is that stress is an individual equation. That has become even more clear to me in recent years as I’ve developed my work with nutrigenetics. We all have a different innate ability to deal with stress and the impact of stress affects us differently too, but these pathways can be supported and attenuated with personalised protocols. Understanding your own stress response can be an empowering way to revamp your life after cancer.
You can find out more about the way I work with nutrigenetics here.
Frances A. Wood, James P Howard, Judith A Finegold et al. (2020) N-of-1 Trial of a Statin, Placebo, or No Treatment to Assess Side Effects. New England Journal of Medicine DOI: 10.1056/NEJMc2031173 (Supported by research grant from British Heart Foundation)