Impact of stress on tumor progression and the molecular mechanisms of exercise intervention: From psychological stress to tumor immune escape
Abstract
Psychological stress is prevalent among cancer patients and has significant effects on both tumor progression and the mental health of patients. Through a biopsychosocial pathway, psychological stress impacts immune function, facilitates inflammatory responses, and hasten tumor growth and metastasis. Consequently, investigating effective ways to mitigate the negative impact of stress on cancer progression holds significant clinical relevance. This review seeks to summarize existing research to delve into the molecular mechanisms by which psychological stress hasten tumor progression and to discuss the potential mechanisms by which exercise, as a non-pharmacological intervention, may mitigate tumor development and enhance the mental health of cancer patients by regulating stress responses. Through a comprehensive analysis of relevant literature, we explore the impact of psychological stress on tumor biology, notably through the activation of the hypothalamic-pituitary-adrenal (HPA) axis, the sympathetic nervous system (SNS), and the promotion of immunosuppression and inflammation. Besides, we review articles on how exercise intervenes in tumor progression by regulating the HPA axis, SNS, strengthening immune function, and suppressing angiogenesis and metastasis. Research confirmed that psychological stress hasten tumor proliferation and metastasis through multiple pathways (e.g., activation of the HPA axis and SNS, pro-inflammatory responses). Exercise may decelerate tumor progression by regulating stress hormone levels, strengthening the immune system function, and lowering the activity of pro-cancer signaling pathways such as VEGF. In addition, exercise boosts the mental health of cancer patients, lowering the incidence of anxiety and depression and enhancing treatment adherence.
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