The influence of cancer on endocrine, immune, and behavioral stress responses

Tumors perturb various physiological systems beyond their local microenvironment, including the immune, nervous, and metabolic systems. Given the involvement of these systems in physiological stress responses, the goal of this review is to compile evidence regarding whether or not cancer alters acute stress responses. Here, we focus on stress responses that are endocrine, immune, or behavioral. This question is clinically relevant as cancer patients are exposed to many stressors throughout diagnosis and treatment, and then later as survivors. Alterations in their stress responses may specifically affect how they respond to advice, treatments, and surgery under duress. To determine whether tumors alone alter stress responses, the relevant literature using rodent cancer models is first reviewed. Next, the more complicated clinical literature in cancer patients is integrated into the discussion. Based on the results of this analysis, goals for future basic and clinical research are proposed. This work aims to advance our understanding of the most effective methods for treating cancer patients and supporting their long-term survival.