Stress Escalates Pancreatic Cancer Growth

Fight or flight hormones could increase the production of tumor nerve cells.

Stress may increase the development of pancreatic cancer by sparking the release of catecholamines, which are known as “fight or flight” hormones, according to a study published by Cancer Cell.

Importantly, the authors discovered that beta blockers can block catecholamines and increase survival among mouse models of pancreatic cancer, according to the study.

The authors also reviewed outcomes of patients with advanced prostate cancer and found that those who took beta blockers survived two-thirds longer than patients who did not take the drugs, according to the study.

Prior studies have indicated that both emotional and psychological stress can contribute to cancer development. This finding is believed to be related to the central nervous system, which releases the hormones in response to danger.

“Some biologists dismissed this idea because stress is hard to measure,” said lead researcher Timothy C. Wang, MD. “Others wondered how stress could possibly be related to a biological process that involves DNA mutations and the growth of cancer cells within a particular organ, such as the pancreas.”

In the study, the authors examined the relationship between stress and the development of pancreatic cancer in mice. Some of the animals were raised under stressful living conditions and the controls were raised in normal housing.

After 14 weeks, 38% of stressed mice developed neoplastic pancreatic lesions, while no controls developed lesions, according to the study.

“We know that you need a DNA mutation to start on the path to cancer, but our findings suggest that stress is doing something to move things along,” Dr Wang said.

Through further evaluation, the authors found that stress corresponded with increased levels of catecholamines in the bloodstream.

Catecholamines were observed to increase production of molecules in the pancreas that stimulate nerve growth. The new nerves then promote cancer development and increases in catecholamines, according to the study.

“In other words, stress sets up what we call a feed-forward loop between nerves and cancer cells that promotes tumor development,” Dr Wang said.

The authors examined mouse models of pancreatic cancer and found that those treated with chemotherapy and beta blockers survived longer than mice treated with chemotherapy alone.

The authors also evaluated the survival of 631 patients who underwent surgery for advanced pancreatic cancer between 2002 and 2013. Patients treated with non-selective beta blockers post-surgery were found to have a median survival of 40 months, which was two-thirds longer than those taking selective beta blockers or no drugs, according to the study.

“It would be premature to recommend the use of beta blockers for these patients until we conduct prospective clinical studies, but beta blockers could potentially become part of the overall treatment regimen for pancreatic cancer,” Dr Wang said.

Other studies have suggested that reducing stress and being positive can help survival. The authors concluded that advising patients to be more positive may slow cancer progression.

“A handful of studies, and a lot of anecdotal evidence, suggest that maintaining a positive outlook is good for your health and can help with recovery from almost any disease,” Dr Wang said. “Will a positive outlook change the prognosis of a patient with advanced pancreatic cancer? Probably not. But it certainly won’t hurt, and it could be part of the overall approach to slowing the progression of cancer to allow other types of therapy to kick in.”