When You Have Chronic Lymphocytic Leukemia, Stress Matters

by Katherine Malmo Health Writer

What is chronic lymphocytic leukemia?

Chronic lymphocytic leukemia (CLL) is the most common form of leukemia. It starts in the bone marrow when the lymphocytes that become white blood cells develop abnormally. CLL is a slow-growing cancer, and it can take years to spread and build up enough in the blood, tissue, and organs to cause symptoms.

Patient facing a serious diagnosis.
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Stress and cancer

Unfortunately, stress and cancer go hand in hand. Finding out that you have cancer can lead to a variety of feelings. Naturally, some patients fear illness and suffering, many will have to deal with financial problems, and some will be stressed by physical discomfort from treatment or the cancer itself. How does this stress impact your health and the progression of the disease? Can stress make cancer worse?

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The survey

Researchers from Ohio State University attempted to answer this question. In their study, 96 CLL patients responded to a survey designed to measure their levels of cancer-related stress. They were asked questions about how intrusive their cancer-related thoughts were, how often they tried to stop thinking about it, and how often they felt jumpy or easily startled.

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The bloodwork

Then the researchers looked at data from blood samples and calculated the measurement of healthy and malignant cells. This measurement is called the absolute lymphocyte count, and is often used as a marker of disease severity. Researchers also measured the levels of eight cytokines – proteins that are part of the body’s immune response and that can create unhealthy levels of inflammation.

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The results

The results showed that patients who reported more stress had more circulating malignant cells and higher levels of three different cytokines than those who reported lower levels of stress.

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The controls

These findings persisted even when researches took several other factors into the account including: gender, the number of prior treatments, and the presence of a genetic marker that is associated with a form of CLL that is harder to treat. Even so, higher levels of stress meant more malignant cells.

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What now?

The association between higher levels of stress and more malignancy means that the implications of stress on cancer patients should not be overlooked. More research needs to be done to clearly identify the path from stress to immune response to inflammation that leads to the cancer’s proliferation.

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Patient care

Newly diagnosed patients should be assessed throughout treatment to determine how much stress they are experiencing and if they have symptoms of anxiety or depression. If so, they should be referred to mental health practitioners for treatment.

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Managing stress

The American Society of Clinical Oncologists (ASCO) points out that while stress does not directly cause cancer, it can weaken the immune system and cause other health problems. To reduce stress they recommend asking for help, prioritizing tasks, being aware of your limits, avoiding scheduling conflicts, breaking down tasks into smaller steps, concentrating on what you can control, and getting help with financial problems.

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Help and resources

A cancer diagnosis often necessitates a lifestyle change, and when thinking about taking care of your health, you should not overlook stress as a factor. The American Cancer Society recommends patients express their fears and concerns to their medical providers, and says that many symptoms of depression, anxiety and stress can be alleviated with the help of medication, support groups and psychotherapy.

Katherine Malmo
Meet Our Writer
Katherine Malmo

Katherine Malmo is a freelance writer and author who was diagnosed with inflammatory breast cancer 13 years ago. Her memoir, “Who in This Room: The Realities of Cancer, Fish, and Demolition,” was published in 2011 and a finalist for the Washington State Book Award. These days, she lives in Seattle and writes mostly about cancer and advances in cancer treatments.