Tag Archive for: Cortisol

How Does Stress Correlate With Your Prostate Cancer Diagnosis?

How Does Stress Correlate With Your Prostate Cancer Diagnosis? from Patient Empowerment Network on Vimeo

How do stress and cortisol levels contribute to prostate cancer incidence and aggressiveness in Black men? Dr. Leanne Burnham explains her research studies where they looked specifically at the role of stress in prostate cancer, tumor aggressiveness, and Black men — and also shares research about cortisol levels in African American children.

See More From the Prostate Cancer TelemEDucation Empowerment Resource Center

Related Resources:

 

What Are Some Hereditary Factors Impacting Prostate Cancer Patients?

Top Tips and Advice for Prostate Cancer Patients and Caregivers Navigating Treatment

Should Prostate Cancer Screening Happen at an Earlier Age for Certain Patient Populations?

 

Transcript:

Dr. Leanne Burnham

I have a few publications that look at the role of stress and prostate cancer, tumor aggressiveness, and Black men. And so, I looked at Black men specifically, because I have wondered if Black men who maybe were exposed to more stressors in their lifetime if that had any correlation to Black men getting prostate cancer earlier in their life and getting a more aggressive disease. And so, there were very realistic ways that we were able to look at that in the lab and then also in collaboration with public health colleagues that I have. Because what we know there are studies that show that African American children experience more stress, and their cortisol levels in their bodies are effective much earlier than any other race, and their studies that show the distress begins in the daycare setting based on discrimination that they may have from the adults that are taking care of them in that setting. And so, imagine cumulatively how that looks, and so we have ways that there are validated scales to assess levels of stressors that people have been exposed to. So that could be…what are your finances looking like? Have you been affected by incarceration yourself or anyone in your family? Have you experienced the death of a loved one? Has your home been broken into recently?

There are all kinds of, there are hundreds and hundreds of questions, and we can get to the root of how much stress has somebody been exposed to. And we know that unfortunately, African Americans in this country are exposed to more of these stressors than other demographics, and so what we did was look at the elevated stress, we could look at the cellular level and see, now if we’re growing prostate cancer cells, so that’s what I did. I was growing cancer cells in the lab that were from Black patients and white patients, and I would expose them to stress hormones in the flask, or maybe you like to think of it as kind of like a petri dish, but in the flask where the prostate cancer cells were growing. I would treat them with stress hormones, and then I would look and see do the cells grow differently, do they express genes and proteins differently based on race? And what I found very surprisingly, disturbingly, whichever adverb you want to use, that the African American prostate cancer cells, when they were exposed to stress hormones, the tumor cells became more aggressive, and they up-regulated genes that we know prime a patient to resist therapy.

So, the genes that were up-regulated in these prostate cancer cells are genes that we know, let’s say if a patient were to get chemotherapy, that patient would be more likely to fail that chemotherapy early, which is a terminology we call chemo resistance. And so those are studies right now that have just sort of, they’re newer to the forefront looking at stress and tumor aggressiveness. But there are studies going on nationwide right now involving thousands of African American men participants, where we are looking at the role of stress and what that does in terms of prostate cancer, aggressiveness in Black men specifically, and seeing what we can do to address it. But first we have to acknowledge that the problem is even there, a lot of people don’t think the problem is there, but we are scientists, we think the problem is there. So, we have to get the data to show the public that the problem is there, and then we need to really address the systemic racism that leads to this elevated and chronic stress that other demographics don’t have to deal with, because it’s literally leading to increased disease and increased health disparities. And if that’s something that we can change at some very basic levels, then that will improve health overall.

Empowerment Tools for Nurturing Your Health During Stress

The pandemic has distorted our livelihood and forced many of us into teleworking whether we were willing or unwilling. We’re plastered to our computers not just in the home office, but at our kitchen tables, or on the bed. We find ourselves having to make adjustments on a regular basis. Responsibilities may have been added to your already hefty plate. Your new work environment may not be favorable. Maybe you simply can’t concentrate. We just can’t seem to escape the pings and alerts from work colleagues. Working from home is new to many of us. However, the concept of work-life balance is not. Yet, instead of home being a sanctuary, it has become a boundless environment for work and stress. Through this journey, we can relearn what work-life balance is, and how intervening factors like stress meddle with our body and mind. We can learn the value mindfulness has in creating boundaries that benefit our health and productivity, and be empowered with tools to build and sustain our immunity.

In the moments we’re experiencing stress we don’t stop to think about the effects it can have on our mind, body, and soul. Being overworked, getting familiar with remote working conditions, or trying to make child-care arrangements can be awfully difficult during a pandemic (Harnois & Gabriel, 2002). Stressors such as these can drive workers into depression, cause sleep disorders, body aches and headaches, and lead to other short- and long- term effects. Job-related stress can affect our immune system by lowering our resistance to infections. Brace yourself, we’re about to hop on the science train, but only for a few stops so you’ll be fine.

Who turned off the lights?

Stress flips the switch on the central nervous system causing it to go into defensive mode (Han, Kim, & Shim, 2012). The body reacts in efforts to regain homeostasis or regain balance. As previously mentioned, stress has the ability to cause depression, sleep disorders, body aches, and a lower immune system. Did you know that stress, sleep, and immunity are related (Han, Kim, & Shim, 2012)? Small immune signaling proteins called cytokines aid in regulating sleep. When these proteins fail to perform properly due to stress, this interrupts phases of sleep. When experiencing this stress, an irregularity in the secretion of the hormone Cortisol occurs.

Depression is a common and complex disorder with the ability to affect your daily life including work and productivity (National Institutes of Health, 2016). The hippocampus, amygdala, and the prefrontal cortex are three parts of the brain that seem to have major roles in depression (Cirino, 2017). When we experience depression, Cortisol secretion increases causing chemical imbalances which can lead to the reduction of brain cells (neurons). In a Korean study published in Stress and Health, individuals who experience work-related stress are at a higher risk of experiencing major depressive issues (Lee, Joo, & Choi, 2013). Symptoms associated with work-related stress include a reduction in the ability to concentrate, fatigue, insomnia, and feeling counterproductive.

An increase in proinflammatory cytokine levels can cause inflammation within the body (Leonard, 2010). This can lead to major depression followed by type 2 diabetes and other inflammatory diseases. Cytokines are involved with adaptive immunity and have been linked to COVID-19 infections (Costela-Ruiz, Illescas-Montes, Puerta-Puerta, et al, 2020). Weakened immune responses have been linked to patients with comorbidities. While the available information regarding COVID-19 is ever changing, what we do know is severe pre-existing conditions, including pregnancy, are linked to weakened immune responses placing these individuals at a higher risk of contracting the virus.

Road to Redemption.

Now that we have a better understanding of stress, learn to set your boundaries to alleviate it. Establish boundaries in all aspects of your life, especially with work. This ensures that your needs and your health are placed at the forefront. Think of them as safeguards for yourself. As difficult as it may be to establish them, understand that they are without question essential for your efficacy in and out of work. Working without boundaries is when stress raids the mind, body, and soul creating an imbalance. Here are a few practices to reclaim your balance: be mindful, create a workable workspace, listen to your body, reevaluate your time, say no.

Being mindful is having that ability to find calm in times of chaos. Be conscious and aware of the moment, relax, and BREATHE. Only you are in control of you. This is a type of meditation that can be implemented in your daily life at any moment. Let’s take a few moments to practice. Stop what you’re doing, turn off the TV, put your laptop to the side, get comfortable, and gently close your eyes. Take a deep breath in, then slowly exhale. If you hear noises, leave them be, continue to breathe. Do this for about 5 minutes. This practice is to help you find your calm, clear your mind, and become hyperaware. This method of nurturing your mind and body has the ability to mitigate stress, anxiety, improve sleep, and improve attention (Mayo Clinic, 2018). There are many practices for mindfulness which can be found on the Complete Guide to Mindfulness.

We are no longer in our offices or confined to our cubicles so we must create workable workspaces, and implement our boundaries. Yes, your new comforter was just shipped from Amazon, but allow the bed to be a place for rest not work. Create a space to enhance productivity yet allow comfort. Here are tips to transform a section of your home into a conducive workspace:

1. Invest in a quality chair and desk/or small table

  • Maintain good posture. If you feel yourself slouching, readjust or move around We want to avoid body aches, so listen to your body. Be aware of its needs.

2. No desk?

  • Use the kitchen table or counter, a coffee table (make sure you have some sort of back support).
  • If you must use your bed because your room is the only place of silence, ensure your bed is made. Sit on top of your new comforter with your back against the headboard

3. Good lighting is a must.

 

4. Keep your workspace organized using bins and folders

  • Disorganization is distracting, limits movement, affects motivation, reduces your performance, and shows lack of control (Roster & Ferrari, 2019).

5. Do not let work leave your workspace. The rest of your home should be designated a non-working area.

Listening to your body is an aspect of creating boundaries. Do not let work interfere with your health. Know when to get up to stretch, grab water, have a snack, or take lunch. If you must, inform your team of the time you will take lunch daily. Having good nutrition is the first thing that will ensure we’re energized and healthy. Instead of ordering something to go for lunch, try meal prepping. Use Sunday as the day to prepare and organize your meals for the week, including your snacks.

Restock on the elderberry! Since we’re all being hyperconscious of where we venture in the world, incorporate things to boost your immune system such as Emergen-C and elderberry. Elderberry is a substance extracted from the elder tree which many use as a dietary supplement to help boost their immune system. It can be consumed in the form of syrup or even gummies. Disclaimer, before the use of any dietary supplement it is best practice to consult your healthcare provider.

Reevaluate your time. You may find that during this time you have accumulated more than 40 hours a week. It’s fine to work additional hours sometimes, but this takes away time from caring for yourself. It interferes with your work-life balance. Although we’re home, this shouldn’t equate to extra time to tap on computer keys. Reevaluating your time takes a level of mindfulness to understand the importance of taking care of you: your mind, your body, your soul.

Saying no can be difficult, especially to a loved one or your boss. However, you should listen to your mind, be aware of what you are capable of, and respect your time. Knowing when to say no in some respects may be less difficult than others. Saying no is powerful. It is the ultimate boundary we can create for ourselves and it is okay.

Our fight with this global pandemic has yet to near the end. If we are equipped with the tools to tackle our stress and adjust as needed, we may be equipped to continue our lives teleworking. We have learned to understand the deteriorating effects stress has on our health. It can disrupt sleep patterns, make us susceptible to depression, and weaken our immune systems. Each one of these conditions are tightly tied together by stress which we must keep unbound. However, the tools to reclaim our balance will aid us in this situation. Being mindful, creating the awareness we need to breathe and focus for productivity in work and life, will assist us in creating needed boundaries. Whether these boundaries are centered around a conducive workspace, listening to our bodies, reevaluating our time, or simply saying no, it is a necessity to properly control and lessen the amount of work-related stress we experience in these crucial times.


References

Cirino, E. (2017). The effects of depression on the brain. https://www.healthline.com/health/depression/effects-brain#1

Costela-Ruiz, V. J., Illescas-Montes, R., Puerta-Puerta, J. M., Ruiz, C., & Melguizo-Rodríguez, L. (2020). SARS-CoV-2 infection: The role of cytokines in COVID-19 disease. Cytokine & growth factor reviews, S1359-6101(20)30109-X. Advance online publication. https://doi.org/10.1016/j.cytogfr.2020.06.001

Han, K. S., Kim, L., & Shim, I. (2012). Stress and sleep disorder. Experimental neurobiology, 21(4), 141–150. https://doi.org/10.5607/en.2012.21.4.141

Harnois, G. & Gabriel, P. (2002). Mental health and work: impact, issues, and good practices. https://www.who.int/mental_health/media/en/712.pdf

Lee, J., Joo, E., & Choi, K. (2013). Perceived stress and self-esteem mediate the effects of work-related stress on depression. Stress and Health, 29(1), 75–81. https://doi.org/10.1002/smi.2428

Leonard B. E. (2010). The concept of depression as a dysfunction of the immune system. Current immunology reviews, 6(3), 205–212. https://doi.org/10.2174/157339510791823835

Mayo Clinic (2018). Mindfulness exercises. https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/mindfulness-exercises/art-20046356

National Institute of Health (2016). Depression basics. https://www.nimh.nih.gov/health/publications/depression/index.shtml

Roster, C., & Ferrari, J. (2019). Does Work Stress Lead to Office Clutter, and How? Mediating Influences of Emotional Exhaustion and Indecision. Environment and Behavior, 1391651882304–. https://doi.org/10.1177/0013916518823041