The subtle repercussions of unnecessary stress

This is a breast cancer specific post so may not appeal to everyone, but as so many people get touched by this disease it’s probably worth five minutes of your time.  Even if you’re not directly affected, your near or dear ones may be. It’s an indiscriminate condition so it affects girls in their teens as well ladies over 70 and any one in between. (It also affects men).

Recent research suggests stress induces breast cancer metastasis (spread) to the bones; this is more often the cause of breast cancer deaths than the initial tumour itself.  (http://www.sciencedaily.com/releases/2012/07/120717183344.htm). Studies  conducted in mice indicate activation of the ‘flight or fight’ response makes bones vulnerable to breast cancer mets.  By looking at the outcomes of women who suffered stress or depression following treatment, researchers identified they also had shorter survival times – stress and depression activate the sympathetic nervous system.  The emerging good news is that it seems beta-blockers, cheap drugs used to treat blood pressure problems, can help prevent bone mets. Let’s hope this proves to be true in human studies as well as the mice models.

The researchers suggest efforts to reduce stress and depression in patients with cancer may have unacknowledged benefits for metastasis prevention.  So until the positive effects of beta-blockers are proven, here’s the thing.  When people are faced with a cancer diagnosis it’s an extremely stressful situation, one of the most stressful anyone is ever likely to face.  Once you get over the initial shock there’s a whole plethora of further investigations, surgeries or therapies to contend with. It’s a lot to take onboard and for a while it turns your whole life (and the lives of anyone close to you) upside down.

During cancer diagnosis, treatment and follow-up, anything that can remain constant – college, relationships, work, family – helps reduce stress, offering the individual some stability in a world where they’ll face a great deal of uncertainty for a protracted period of time.   So I find it sad to report that in many instances, these constants are also swept away and often for no good reason.  In talking with friends who’ve been on this journey, I’ve been surprised and dismayed to hear how many of them have been abandoned by people they considered good friends, prevented from continuing their studies or disadvantaged by their employers. Some have even been made to feel a nuisance or burden by their own family members, finding themselves cast aside in their hour of greatest need. Every one of these situations causes extra stress. Every one of them could be avoided.

We can speculate about the causes of this bizarre behaviour (it’s the 21st Century, we are supposed to be civilised) but it would appear it stems from the same roots as the majority of bizarre human behaviour.

  • False assumptions about cancer:  similar to the false assumptions that sometimes get made about black people. Many of my best friends are black and get misjudged solely on their appearance – it never ceases to amaze me.
  • False assumptions about how a person with cancer might change: similar to the doubting comments that sometimes get made about pregnant women – are they committed to anything other than the child?  Still happens.
  • False assumptions about what a person surviving cancer will want or be capable of:  like suggestions that sometimes get made about older people – can they cope, are they up to it. Still happens too.
  • False assumptions that cancer is the persons fault so they’re using it as an excuse: similar to the way parents sometimes think children make excuses to stay off school or avoid their homework. Most people don’t make excuses about cancer, it’s not their fault, they aren’t being lazy or burdensome.

So many of these stereotypical assumptions lead to prejudice and persecution.  But it  strikes me that by 2012 we really ought to have a handle on this.  We ought to be able to appreciate each others differences whether its skin colour, age, physical state, cancer or any other attribute that differentiates one group of people from another.  It’s kind of sad that we still need laws to protect some groups from others and whilst the law in Europe and many other parts of the world is meant to prevent disadvantage – in education, when accessing services or at work –  it seems some people are still willing to flout it. And if bonds of blood aren’t strong enough to prevent family members neglecting a brother, sister, wife or child with cancer then what hope can the law possibly offer?    We’ve seen claims for asbestos exposure, corporate manslaughter, disability discrimination and PTSD. Recently a grandmother was sued by her family for falling downstairs while carrying her baby granddaughter who was left severely disabled…. will we see respondeat superior or vicarious liability claims for stress induced breast cancer mets at some point in future too?  Draco dormiens nunquam titillandus.  But law isn’t really the answer. If only common sense weren’t so uncommon, if a little bit of compassion, dare I say it standing in the other (often disadvantaged) persons shoes for a while could be offered, then these situations need never arise.  Sadly it seems some people still have a lot of work to do when it comes to developing these most simple, yet fundamental, human traits.

 

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