Anita Malik (name changed), a 32-year-old, Mumbai-based media professional remembers being shocked when her oncologist told her that one of the main things she’d have to do to avoid the recurrence of her breast cancer was to manage her stress. “I didn’t know how to react,” she says, “My job as a digital media manager is extremely stressful as the working hours are long, unpredictable with sky-high targets. How do I avoid that?” On further probing, Malik also shared that her personal life was a mess, with a toxic relationship leading to emotional turmoil and unrealistic expectations from her family. “I knew at that instant that I needed to change my life’s canvas and paint a new, healthier picture for myself.”
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Malik’s story might not be the same for all cancer patients and survivors, but many patients do admit that their doctors have told them to not take prolonged stress and avoid it, at all costs. Dr Mridul Malhotra, Senior Consultant and Head of Medical Oncology, at Asian Hospital, points out that animal models have shown that cancer in mice, who were subjected to stress, had higher chances to spread to other body parts. This could be attributed to hormones like norepinephrine and glucocorticoids released during stress, which in turn, could create an environment or cancer to grow and spread, she adds.
At the same time, stress can have an indirect link since it leads to unhealthy behaviours like smoking, overeating, becoming sedentary, or drinking alcohol, which themselves increase the risk of cancer. And yes, as Dr Sajjan Rajpurohit, Director-Medical Oncology, Max Super Specialty Hospital, Shalimar Bagh points out, there is also evidence to suggest that stress can make existing cancer worse. “One study found that patients with breast cancer who experienced high levels of stress were more likely to have their cancer come back than those who didn't experience high levels of stress,” he says.
Stressors can arise from people’s daily responsibilities and routines, including work, family, and money. Early life adversity, exposure to certain environmental conditions, poverty, unhealthy lifestyle, and sedentary profession can also be stressors. Malik, for instance, recalls that the two to three years before her cancer diagnosis were that of extreme emotional upheaval, filled with uncertainty leading to her smoking, overeating and leading a sedentary lifestyle.
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But while it is hard to eradicate stress completely, there are some things one can do to manage it better, especially when you are dealing with a cancer diagnosis.
Create a support system
Emotional and social support can help patients learn to cope with stress. And help overcome depression, anxiety, and disease- and treatment-related symptoms. Some studies have shown that better social support improved outcomes in breast and ovarian cancer.
Physical fitness is the key to mental health. Yoga, pranayama, meditation, and workouts including weight training and cardio exercises, all have been shown to release happy hormones and reduce the hormones that cause stress.
Talk to professionals, including psycho-social counsellors. Sharing or expressing in support groups of cancer patients relieves stress and also brings confidence among those dealing with stress. Coping mechanisms shown to be helpful for managing anxiety and distress in cancer survivors include mindfulness-based stress reduction and cognitive behavioural therapy. Access to cancer support helplines for both patients and caregivers also proves beneficial and improves outreach.
Watch your diet
Eating a healthy diet rich in fruits and vegetables is important for overall health and well-being and helps reduce stress and stay fit.
Divya Naik is a Mumbai-based therapist