The impact of psychological stress and depression on cancer progression: exploring biopsychosocial mechanisms and patient outcomes

Abstract

Objectives. In 1946, the World Health Organization (WHO) defined health as “a complete state of physical, mental, and social well-being, not merely the absence of illness or disease.” This highlights the interconnectedness of mental and physical health. Chronic stress and depression significantly influence cancer progression and outcomes, disrupting balance, impairing immunity, and promoting tumor growth. Depression worsens quality of life, increases mortality, and complicates treatment [1]. Addressing these factors is crucial for improving care, prognosis, and well-being in cancer management. Materials and methods. A literature review was conducted following PRISMA guidelines. Twenty-one medical articles published within the last five years were analyzed, focusing on the interplay between stress, depression, and cancer progression. The studies were selected based on relevance, methodological rigor, and adherence to the PRISMA framework. Results. Chronic stress and depression significantly worsen cancer progression by disrupting homeostasis and immune responses, leading to tumor growth and metastasis [2]. Stress hormones, like glucocorticoids, suppress natural killer (NK) cell activity and enhance angiogenesis and genomic instability [3,4]. Depression, prevalent in 30% of cancer patients, reduces serotonin levels, compromising immune defense and treatment adherence [5]. Patients with depression face higher mortality, prolonged hospital stays, and increased readmission rates [6]. Stress also activates betaadrenergic signaling, promoting tumorigenesis through p53 degradation [7]. Additionally, stressinduced autophagy further supports cancer proliferation, particularly in aggressive forms like gastric cancer, highlighting the multifaceted ways psychological factors exacerbate tumor behavior [8]. Conclusions. Chronic stress and depression exacerbate cancer progression through endocrine, immunological, and behavioral pathways. Interventions addressing these psychological factors can improve survival rates, treatment compliance, and overall quality of life for cancer patients. Recognizing and managing the biopsychosocial aspects of cancer care is essential for holistic patient management.