Chronic stress of cancer causes accelerated telomere shortening

Results of a study presented at the AACR 102nd Annual Meeting 2011, held here April 2-6, lend credence to the idea that improving quality of life affects stress-related biological markers and possibly the health of people with cancer.

Researchers know that telomeres shorten and deteriorate with ageing, but they are learning that stress also affects telomere length.

'We are trying to understand the interconnections between the mind and the body; that is, how does the diagnosis and treatment of cancer impact patients not only psychologically, but also physiologically and how can we improve their outcome. Cancer drives a chronic stress response in some patients,' said Edward Nelson, M.D., division chief of haematology/oncology at the University of California, Irvine.

Just as aglets prevent a shoelace from unravelling or fraying, telomeres are structures on the ends of chromosomes that protect the chromosome from deteriorating, breaking apart or joining with other chromosomes, which can lead to mutations. Chromosomal rearrangements are seen in cancers and provided a biological reason to investigate this link, according Nelson.

'For this study, we wanted to know if chronic stress was associated with accelerated telomere shortening in cancer patients, and if a psychosocial intervention that modulates the stress response could also modulate telomere length,' he said.

In this retrospective study, the researchers took biological samples from 31 women with cervical cancer who had been randomised to one of two groups - those who received six counselling sessions by telephone and those who received usual care without counselling.

The six sessions consisted of a quality of life and psychosocial profile, managing stress and emotions, enhancing health and wellness, addressing relational and sexual concerns, and integrating and summarising the information. At enrolment and after four months, the researchers obtained biological samples from both groups and investigated changes over time to see if psychological counselling had any physical effects.

'Improved quality of life and reduced stress response was associated with changes in telomere length,' Nelson said.

'It is important to recognise that this was an exploratory and preliminary analysis. We embarked on the first study of telomere length and chronic stress in a cancer population and the first longitudinal analysis in whether changes in quality of life and changes in the stress response would be associated with modulating the telomere length,' he said.

Still, he added, 'there is no doubt that offering psychological services has the potential to improve quality of life and outcomes of patients. After all, making patients feel better should be an outcome that a cancer team should want to have, but whether we can draw conclusions or make recommendations about the capacity of a behavioural intervention to modulate telomere length remains an open question.'