Payne Judith K
University of Wisconsin Hospital and Clinics, Madison.
Oncol Nurs Forum. 2014 Sep;41(5):533-40. doi: 10.1188/14.ONF.533-540.
Diagnosis with a life-threatening illness such as cancer is almost universally experienced as stressful. The construct of stress has received substantial consideration as a correlate or predictor of psychological and health outcomes (Andersen et al., 2004) and has often been conceptualized within a stress and coping framework (Lazarus & Folkman, 1984). Biobehavioral factors have long been thought to affect many health processes. The relationship between inflammation of stress and cancer originated centuries ago and is now recognized as a facilitating characteristic of cancer (Mantovani, Allavena, Sica, & Balkwill, 2008). In addition, stress and the stress response are probable mediators of the effects of psychological factors on cancer, and specifically on progression of cancer (Powell, Tarr, & Sheridan, 2013). A substantial amount of new research activity has enlightened scientists and clinicians on the neuroendocrine regulatory function of physiologic pathways in cancer growth and progression (Lutgendorf & Sood, 2011). However, in spite of considerable research over the past several decades, inconsistent data remain a challenge in establishing evidence-based pathways between behavioral risk factors and cancer initiation.
被诊断患有癌症等危及生命的疾病几乎普遍会让人感到压力巨大。压力这一概念作为心理和健康结果的相关因素或预测指标已得到大量关注（安德森等人，2004年），并且常常在压力与应对框架内被概念化（拉扎勒斯和福克曼，1984年）。生物行为因素长期以来一直被认为会影响许多健康过程。压力引发的炎症与癌症之间的关系起源于几个世纪前，如今被认为是癌症的一个促进特征（曼托瓦尼、阿拉韦纳、西卡和巴尔克威尔，2008年）。此外，压力和应激反应可能是心理因素对癌症影响的中介，特别是对癌症进展的影响（鲍威尔、塔尔和谢里丹，2013年）。大量新的研究活动让科学家和临床医生对生理途径在癌症生长和进展中的神经内分泌调节功能有了更深入的了解（卢特根多夫和苏德，2011年）。然而，尽管在过去几十年里进行了大量研究，但在建立行为风险因素与癌症发生之间基于证据的途径方面，数据不一致仍然是一个挑战。
