A cancer diagnosis and chemotherapy treatment can be stressful and distressing.

Now researchers are looking at measuring stress, and the impact of stress, to facilitate earlier detection and intervention, focusing on women receiving treatment for breast cancer. 

A new study at Flinders University is looking at different ways of measuring stress and the stress response in women receiving treatment for breast cancer, including analysing levels of the stress hormone cortisol in patients during chemotherapy. 

During times of stress, extra cortisol is made by the adrenal glands and helps a person survive that stress, experts say. However, too much cortisol long-term can cause chronic health problems, such as obesity, diabetes and heart attacks.

Kickstarted by a philanthropic donation from a generous Adelaide benefactor, the project brings together a multidisciplinary team including oncologist and cancer survivorship researcher Professor Bogda Koczwara, psychology researcher Associate Professor Sarah Cohen-Woods, molecular biologist Associate Professor Michael Michael and endocrinologist Associate Professor Morton Burt. 

“While a cancer diagnosis can put enormous stress on a patient, steps can be taken to reduce its impact through health promoting interventions such as exercise, healthy diet and mindfulness” Professor Koczwara says. 

“These interventions not only improve psychological wellbeing but may also improve cancer outcomes, reducing the risk of the development of  comorbid chronic conditions after chemo – including metabolic and cardiovascular disease.

“Research shows that continuous exposure to various stressors has been associated with dysregulation of cortisol within the hypothalamic-pituitary-adrenal (HPA) axis, impairing the body’s central nervous system and endocrine response.

Until recently, one challenge has been difficulty measuring levels of cortisol to assess exposure to the critical stress hormone cortisol.”

“Our study will provide information on the feasibility of measuring cortisol in patients with cancer using their hair samples to assess variation in results and change following chemo administration,” says Professor Koczwara. 

The pilot study will collaborate with a specialised research laboratory in Dresden, Germany undertake the measurements. 

Associate Professor Burt adds that when a patient starts chemo, the HPA axis may become dysregulated not just because of the direct stress effect, but also because of the high dose of exogenous steroids administered to patients to manage nausea and other side effects. 

“Our research would enable proof of concept testing cortisol in using hair analytic techniques, which could pave the way for a detailed examination of the role of cortisol in stress reported by cancer patients, in premature ageing, and development of chronic disease after cancer and cancer progression, all of which are of great importance and interest in cancer survivorship research and, most importantly, to cancer survivors,” adds Associate Professor Cohen-Woods. 

The new research aligns with the Flinders Cancer Survivorship Group priorities for research in breast cancer survivorship and with the commitment to support research into wellness as part of the Flinders Wellness Centre at the Flinders Centre for Innovation in Cancer.