The co-authors of Invasion of the Prostate Snatchers, blog alternate posts weekly. We invite you to post your comments.

Tuesday, October 1, 2013

Stress Management


Shining a light on stress from a different angle always yields new insights. The very term “stress management” is like a suitcase you can unpack layer by layer.

There can be no doubt that emotional factors influence biology. Some studies indicate that stress plays a role in causing the occurrence and recurrence of prostate cancer. In fact, most major illnesses have been linked to chronic stress.

Receiving a diagnosis of cancer, and living with cancer, can cause an enormous burden of stress. While experiencing feelings such as depression, despair, anger and fear is totally understandable, if those feelings are not recognized and  “managed,” they put endless wear and tear on the body until eventually the immune system—our most powerful defense against cancer—is no longer capable of performing its job efficiently.

The body has its own stress inhibitors.  Consider cortisol. Known as the “stress hormone,” cortisol is synthesized from cholesterol, produced in the adrenal cortex, and secreted during a stress response. Among cortisol’s primary functions are: to aid in fat and protein metabolism, and to redistribute energy to those regions of the body that need it most; for example, to the brain and major muscles during a fight-or-flight situation. Most important, cortisol helps to regulate the body’s inflammatory response to stress, which it does by increasing blood sugar through the process known as  gluconeogenesis. However, during long periods of chronic stress, cortisol is over-produced, and when cortisol levels are too high, the result is a disruption of its anti-inflammatory function.

Led by Sheldon Cohen, professor of psychology and director of the Laboratory for the Study of Stress, Immunity and Disease at Carnegie Mellon University, a teamof researchers found that chronic psychological stress was associated with the body losing its  ability to regulate its inflammatory response and fight infection. They found that, over a prolonged period of stress, body tissue becomes desensitized to cortisol and the hormone loses its effectiveness in regulating inflammation. As a result, disease can prosper.

The links between psychological stress and metastatic growth of disease suggest that stress management should be an integral part of cancer treatment—and possibly the treatment of all inflammatory diseases.

After I completed six weeks of Intensity Modulated Radiation Therapy (IMRT) at St. John’s Health Center in Santa Monica, California, part of the post-procedural concern was monitoring levels of inflammation. For that reason I continued to take Avodart, a drug that both inhibits the transition of testosterone to the more pernicious dihydrotestosterone and acts to keep inflammation levels down. At the same time, I began consciously to monitor my own stress levels and mindfully work to diminish them.

Practically speaking, one thing we can we do is to consider the potential benefits of “mind-body medicine,” which embraces such practices as relaxation therapy techniques, yoga, meditation and tai chi, all of which have been found to be useful as de-stressing activities.

For those of you who think of meditation as an exotic eastern exercise, check out Meditation for Dummies by Stephan Bodian (Wiley Publishing). On the other hand, some people respond well to biofeedback or hypnotherapy. Moreover, it seems that just stroking your pet cat or dog for a few minutes each day has a significant calming effect.

At the very least, adding some form of stress management to whatever conventional treatment you elect to undergo will certainly improve your quality of life—and at the same time enhance your chances of recovery.

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