Cancer Builds a Noxious Partnership with Psychologic Stress

I was recently surprised to hear a medical doctor on a TV show refute the role of stress in cancer, assuming that "the whole population would have cancer if this was the case." This statement illustrates a long and winding road since Hippocrates suggested the potential relationship between cancer and psychologic disturbances. The 20th and 21st centuries have finally witnessed the evidence of how physical or psychosocial stress situations contribute to the development and progression of cancer, and it is now assumed that psychologic stress does affect multiple aspects of cancer such as angiogenesis, immunologic escape, invasion, and metastasis. The 2010 publication by Sloan and colleagues in Cancer Research achieved a mechanistic step toward the understanding of how physical distress enhances metastasis through perturbation of the tumor immune system and paves the way for future cancer research in psychoneuroimmunology. This Landmark commentary places this publication in the historical context of science, discusses major advances in the field, and asks questions to be answered while drawing perspectives on the key role of the peripheral and central nervous systems in cancer. See related article by Sloan and colleagues, Cancer Res 2010;70:7042-52.