Research Progress on the Mechanisms of Chronic Stress Affecting Tumor Development
JIANG Haoyu1,2, JIANG Beibei2, JIN Weibo1, ZHANG Dawei2*, ZHANG Jin2,3*
Chronic stress disrupts hormonal balance via the neuroendocrine system and is increasingly recognized as a critical factor contributing to poor prognosis in tumor patients. Cancer patients often experience recurrent negative emotions such as anxiety and irritability throughout disease progression and treatment, and this persistent chronic stress state can accelerate tumor progression and compromise therapeutic efficacy. Emerging evidence suggests that neuroendocrine activation not only exerts direct effects on tumor cells but also modulates the physiological behavior of non-cancerous cells in the tumor microenvironment. This review first outlines the process of stress signal transduction underlying stress and subsequent intracellular pathway activation. It then discusses how chronic stress facilitates tumor progression through regulating tumor cell autonomous effects (including proliferation, migration, autophagy modulation, and metabolic reprogramming), remodeling the tumor microenvironment (involving changes in immune characteristics, angiogenesis, and epithelial-mesenchymal transition), and disrupting gut microbiota homeostasis. Finally, based on the existing clinical treatment and drug development progress of tumors and chronic stress, the review summarizes pharmacological intervention strategies targeting the neuroendocrine system, providing potential directions for the comprehensive treatment of cancer patients under chronic stress.
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