For years, researchers have been looking at a possible link between women who lead particularly stressful lives and a higher incidence of breast cancer. There continues to be quite a bit of confusion because some studies have found that stress may be associated with an increase in breast cancer risk, while other studies came to a polar opposite conclusion suggesting no such link. These conflicting (and confusing) findings are the result of the different methods the various researchers used to conduct their studies in the first place. The size of a study can also impact the results, with small number of participants creating less reliable outcomes.

Since most of us face a variety of stresses each and every day, the last thing any of us wants is to have the added worry that when we are dealing with a difficult life situation, we may also be priming ourselves for breast cancer. And, quite frankly, there are few things more stressful than a diagnosis of breast cancer!

Some Dutch researchers did a meta-analysis where they combined the results of 27 studies that had looked for a link between breast cancer and stress. They looked for a possible increase in the rate of a breast cancer diagnosis within 6 months of the women being studied experiencing stressful life events. They looked at the following stressors:

• Death of a spouse
• Death of a relative or friend
• Personal health difficulties
• Non-personal health difficulties
• Change in marital status
• Change in financial status
• Change in environmental status, and
• Miscellaneous stressful life events.

They also looked at the effects of publication bias and heterogeneity (comparing studies with very different designs).

In their meta-analysis, the researchers discovered a statistically significant link (a link that is most likely not due to chance) between three of the eight types of stress and breast cancer risk. These were:

• The death of a spouse (associated with a 37% increase in risk).
• The death of a relative or friend (associated with a 35% increase in risk).
• Miscellaneous stressful life events (associated with a 77% increase in risk).

Interestingly, divorce appeared to have no impact on breast cancer risk (remember, this was within 6 months after the divorce!) It is also interesting to note that the researchers felt that significant publication bias and heterogeneity made these findings particularly weak in the categories of miscellaneous stressful life events and the death of a relative or friend – which caused them to feel these two findings were not significant. Other problems they found were that there is a great variation in stressful events. For instance, a woman with small children who has a divorce that drags on for several years will have a very different experience than a woman who is able to get a quick annulment after a brief marriage that produced no children.

Additionally, the follow-up on the various studies was much too short. It is felt that ten years is the minimum time necessary to follow someone after a stressful event in order to actually look at whether stress causes breast cancer. Since cancer begins with a small growth of cells, it generally takes several years before even a small cancer is discovered.

The Dutch study concluded that based on their analysis of 27 studies, there was no significant link between most stressful life events and an increase in breast cancer risk (remember, this is within 6 months of experiencing these events.)

On a much more simplistic level, let’s take a look at how the reaction to stress just might be something we want to think about in terms of our risk of breast cancer (or other cancers for that matter!) What about smoking cigarettes? Why do most people light up? Certainly, the nicotine is highly addictive, and this accounts for that continuous reach into our purse, drawer or pocket for the nearest pack. But just how many people reach for a cigarette when they feel stressed?

A recent five-year study showed that the risk of breast cancer rose significantly with the number of years and the number of cigarettes women had smoked. The longer the women smoked, and the more cigarettes they smoked per month, the greater their risk of breast cancer. So if stress is contributing to your desire to smoke, then it most certainly could be a contributing factor, although somewhat convoluted!

And how about obesity? We do know that people often head for their refrigerators or pantries in response to stressful situations. If stress eating leads to obesity and obesity is linked to an increased risk of breast cancer, then, once again, there is a cause and effect type of link between the two.

Perhaps a proactive way to deal with this issue regardless of whether or not stress is directly related to breast cancer is finding ways to eliminate as much negative stress in our lives as possible. Some stress is actually good. You wouldn’t get out of bed in the morning if there wasn’t some stress in your life! Some degree of stress helps all of us to perform better. Positive stress, such as the birth of a child, a job promotion, or a new relationship can result in a renewed sense of awareness and a positive, even exciting perspective. We all thrive under a certain amount of stress.

The stress you want to be concerned about is the type that is unrelenting and life altering in negative ways. Here are just a few stress relievers that may come in handy to help you cut down on stressful situations that wear you down:

• Prepare for your morning the evening before. Figure out what you are having for breakfast. 
• Make lunch (if you take your lunch!) Put out the clothes you plan to wear so you don’t have to make a last minute dash for any of these items. 
• Make it a practice never to do something you’ll have to lie about later. 
• Procrastination is stressful. If you can accomplish something in the here and now – do it!
• Plan ahead. Don’t let your gas tank get below one quarter full. Keep your pantry well stocked. Even keeping something as simple as postage stamps in the ready will help eliminate stress the next time you are in a hurry and need a stamp!
• Are there things in your life that are a constant source of aggravation? Identify them and eliminate them. This may be as simple as getting a new toaster – or as difficult as finding a new job. Regardless of the source, finding a positive outcome will do wonders for your stress levels!
• Give yourself an extra 15 minutes whenever possible. Start your day 15 minutes earlier so that when those inevitable morning mishaps occur, you’ve built in a time buffer for yourself. The same goes for appointments. Leave 15 minutes earlier so if there is traffic or any other delay, you won’t be adding to your stress by cutting the time too close for comfort. 
• Get enough sleep! No ifs, ands, or buts! 
• Write your thoughts and feelings down on paper. This can help you clarify those things that bring you joy and those things that just annoy!
• Monitor your body for signs of stress. How’s your stomach feeling? How’s your breathing? Are your ears between your shoulders? If your stomach is in knots, your breathing is shallow, and you have to look up to see your shoulders – it’s time to relax, relax, relax! 
• Did we mention, find ways to relax? Take up yoga, tai chi, meditation or some other form of relaxation. Let your mind and body unwind. 
• Do something you enjoy each and every day. 
• Learn to live one day at a time. 
• Visualize success before you start any endeavor about which you are apprehensive or fearful. 
• Count your blessings. 
• Learn to say no and not feel guilty. 
• Always have a back up plan so you don’t feel trapped in any given situation. 
• Remember that perfection simply doesn’t exist – so lighten up and find ways to enjoy life’s imperfections. 
• When you take a lunch break, make sure you get away from work in both body and mind.  
• Let your cell phone take a vacation. Either turn it off or put it where you can’t hear it and then take a nice hot bath or pamper yourself in some other way. Create some quiet time for yourself each and every day. 
• If you have to do something unpleasant, do it early in the day so you get it over with and can enjoy the remainder of the day as it unfolds. 
• Stop negative self-talk. If you find that little voice telling you “I’m too fat, I’m too old, I’m not good enough, etc., try to bring your focus to something you like and concentrate on that.

The list of coping mechanisms could go on and on, but this at least gives you a place to begin. There are probably as many ways of coping with stress as there are stressful situations. The bottom line is to find ways to help your mind and body unwind so they can just let go.

Experimenting with what works for you will help the next time you find yourself dealing with a difficult life event. Creating a good support system and utilizing successful coping strategies should help to diminish the negative effects stress can have on your body. And that’s a good thing regardless of whether there is a direct link between stress and breast cancer.

Obviously, more research is needed to help evaluate the various coping strategies so that we can all look stress straight in the eye and come out healthy and happy!