Abstract
Mounting preclinical and clinical evidence continues to support a role for the neuroendocrine system in the modulation of tumor biology and progression. Several studies have shown data supporting a link between chronic stress and cancer progression. Dysregulation of the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenal (HPA) axis has been implicated in promoting angiogenesis, tumor cell proliferation and survival, alteration of the immune response and exacerbating inflammatory networks in the tumor microenvironment. Here, we review how SNS and HPA dysregulation contributes to disturbances in immune cell populations, modifies cancer biology, and impacts immunotherapy response. We also highlight several interventions aimed at circumventing the adverse effects stress has on cancer patients.
Highlights
The stress response is a biological process mainly mediated by the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenal (HPA) axis
These studies indicate that stress hormones directly impact tumor cells and Tumor-associated macrophages (TAMs) while enhancing tumor growth and impairing immune function
Chronically stressed mice exhibited greater tumor burden associated with the infiltration of Myeloid-derived suppressive cells (MDSCs) [19, 40] in the tumor tissue and enhanced suppressive activity toward proliferating T-cells [19]. These results suggest that there is a significant link between stress, MDSC-induced immunosuppression, and cancer
Summary
The stress response is a biological process mainly mediated by the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenal (HPA) axis. Activation of the SNS and HPA axis leads to the release of neurotransmitters and hormones, such as catecholamines and glucocorticoids. These molecules mediate many biochemical and physiologic changes (e.g., increased heart rate, rapid breathing, perspiration). Prolonged activation of the SNS and HPA axis, known as chronic stress (occurring over weeks or years), increases the exposure of the immune system to elevated stress hormone levels. The increased exposure to stress hormones disrupts physiological homeostasis and could serve as a risk factor for the development and progression of many diseases, including cancer [2,3,4]. One of the primary mechanisms by which chronic stress affects cancer progression is through alterations in humoral and cell-mediated immunity. Chronic stress can lead to variations in the proliferative capacity of lymphocytes
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
