Stress spectrum disorders in oncology.
OBJECTIVE
In this study, we will review the clinical, biological and research challenges resulting from the application of the traumatic stress framework to the psychological experience of cancer. Theoretical controversy over that conceptual shift and tentative neurobiological correlations are discussed. We will attempt to extract significant advances from the general literature and describe new directions for therapeutic strategies.


RESULTS
The traumatic nature of cancer experience is supported by epidemiology, but criticized by many authors, highlighting methodological caveats and conceptual contradictions. However, neuroimaging studies provide common findings in cancer patients with posttraumatic stress disorder, as it has been described in posttraumatic stress disorder patients. The carcinogenic effects of catecholamines and glucocorticoids could open the way for a deeper understanding of correlations between psychological factors and cancer prognosis.


CONCLUSIONS
Cancer is a unique psychological experience. Its relapsing course and life-threatening nature constitute a potential source of severe and chronic stress, resulting in long-term psychological distress, poor quality of life and psychopathology. Biological consequences of cumulative stress include catecholamine hyperactivity and glucocorticoid dysregulation, and also affect the immune system. The understanding of those physiopathologic pathways needs further investigation, as the development of adequate screening tools does. In order to integrate all those challenges, multidisciplinary approaches are warranted.
Institut Jules Bordet, Université Libre de Bruxelles, Psycho-Oncology Unit, Belgium. patrick.desaive@bordet.be
Patrick
P
Desaive
Alain
A
Ronson
D006801:Humans; D009369:Neoplasms / Q000503:physiopathology* / Q000523:psychology; D013315:Stress, Psychological / Q000503:physiopathology* / Q000523:psychology