ABSTRACT
The conviction of the association between stress and emotional difficulties, due to the relationship difficulties, stressful life events that compromise physical and psychological well-being, and cancer occurrence, is often expressed by patients and it is supported empirically by the anecdotal clinical evidence. The results of a meta-analysis overall supported only a modest association between specific psychosocial factors and breast cancer. Prolonged exposure to stress produces an endocrine activation through the Hypothalamic-Pituitary-Adrenal (HPA) axis, that increases cortisol, a substance that is powerfully immunosuppressive. Maunsell evaluated the relation of stressful life events with survival after breast cancer. However, breast cancer, for example, is now recognised as a slow-growing tumour with a long sub-clinical phase that, in some women, extends to 18 years or more. Design of the study is a prospective cohort study with a biopsychosocial approach. For this preliminary assessment patients were all interviewed after surgery, before discharge.
