ReviewNature reviews. Cancer2021
Stress and cancer: mechanisms, significance and future directions.
Review in Nature reviews. Cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 199 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
199 citing papers in PubMed, 7 syntheses or guidelines pooled it, 308 citations in OpenAlex.
- Mapping Psychosocial Determinants for Cancer Onset: An Umbrella Review.Psycho-oncology · 2026Pooled it
- The Impact of Chronic Stress on Treatment Outcomes of Cancer Patients with Divergent Survival Rates: A Systematic Review.International journal of molecular sciences · 2026Pooled it
- Pooled it
- Effect-enhancing and toxicity-reducing effects of Chaihu Jia Longgu Muli decoction in the treatment of multimorbidity with depression: a systematic review and meta-analysis.Pharmaceutical biology · 2023Pooled it
- Acceptance and commitment therapy reduces psychological distress in patients with cancer: a systematic review and meta-analysis of randomized controlled trials.Frontiers in psychology · 2023Pooled it
- A meta-analysis of the association between post-traumatic stress disorder and cancer risk.Frontiers in psychiatry · 2023Pooled it
- Psychological distress and coping strategies in breast cancer patients under neoadjuvant therapy: A systematic review.Women's health (London, England)Pooled it
- Favorable safety outcomes of a perioperative propranolol and etodolac regimen in cancer patients in four randomized controlled trials.Frontiers in pharmacology · 2026Trial
- A Remote Time-Restricted Eating and Mindfulness Intervention Addressing Risk Factors Associated with Early-Onset Colorectal Cancer Demonstrates Feasibility and Acceptability among Young Adults: A Randomized Controlled Pilot Trial.Nutrition and cancer · 2025Trial
- Prognostic significance of dynamic emotional distress during neoadjuvant therapy and surgery for resectable non-small cell lung cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Neural-tumor interactions: bidirectional regulatory mechanisms and nervous system-targeted tumor therapeutic strategies.Biomarker research · 2026Review
- Neighborhood gentrification, income inequality, and cancer incidence among Hispanic/Latino adults.JNCI cancer spectrum · 2026Article
- Cancer Neuroscience: From Local Neuro-Immune Microenvironments to Systemic Brain-Body Circuitry.MedComm · 2026Review
- Emotional distress and clinical response to neoadjuvant chemoimmunotherapy in resectable non-small-cell lung cancer: a protocol for the prospective observational NeoFUSE-Lung cohort study.Translational lung cancer research · 2026Article
- Psychological Stress Promotes Tumor Growth in Hepatocellular Carcinoma Models Through Myeloid Signaling.Cancer science · 2026Article
- Depression remodels tumor microenvironment to drive tumor progression: Bio-behavioural signalling pathways and clinical interventions.Journal of advanced research · 2026Review
- Article
- Endogenous glucocorticoids and glucocorticoid receptor signaling: Dual regulators of PD-1/PD-L1 immunotherapy efficacy in the tumor microenvironment.Chinese medical journal · 2026Review
- Chronic stress unleashes an intratumor phage-fibroblast-B cell circuit to promote tumor growth.Cancer cell · 2026Article
- Enriched environment inhibits melanoma by reshaping gut microbiota and enriching Parabacteroides distasonis.Cellular oncology (Dordrecht, Netherlands) · 2026Article
139 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The notion that stress and cancer are interlinked has dominated lay discourse for decades. More recent animal studies indicate that stress can substantially facilitate cancer progression through modulating most hallmarks of cancer, and molecular and systemic mechanisms mediating these effects have been elucidated. However, available clinical evidence for such deleterious effects is inconsistent, as epidemiological and stress-reducing clinical interventions have yielded mixed effects on cancer mortality. In this Review, we describe and discuss specific mediating mechanisms identified by preclinical research, and parallel clinical findings. We explain the discrepancy between preclinical and clinical outcomes, through pointing to experimental strengths leveraged by animal studies and through discussing methodological and conceptual obstacles that prevent clinical studies from reflecting the impacts of stress. We suggest approaches to circumvent such obstacles, based on targeting critical phases of cancer progression that are more likely to be stress-sensitive; pharmacologically limiting adrenergic-inflammatory responses triggered by medical procedures; and focusing on more vulnerable populations, employing personalized pharmacological and psychosocial approaches. Recent clinical trials support our hypothesis that psychological and/or pharmacological inhibition of excess adrenergic and/or inflammatory stress signalling, especially alongside cancer treatments, could save lives.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.