We know that myeloma goes away but that it most often returns out of remission. Myeloma experts hypothesize that the treatment kill some but not all of the myeloma clones and the reasons for relapse are unknown at this point in myeloma. According to lung cancer researchers, other factors like stress could actually contribute to the waking up of dormant cancer cells.

In a recent study published in Science Translational Medicine, researchers found that certain stress hormones and trigger a chain of events that reawaken these dormant cancer cells. 

The research reviewed the immune system's role in reawakening cancer that had been in remission for years. The type of immune cell studied is known as polymorphonuclear neutrophils (PMNs).

When researchers found that PNMs release a type of lipid that wake up dormant tumor cells, they worked backwards to see what triggered the release of the lipids. They identified the trigger as the stress hormone called norepinephrine. The study presented data from 80 lung cancer patients, of whom 17 had an unusually early relapse. These 17 patients had higher blood levels of this lipid compared to patients in longer periods of remission. Lead author Michaela Perego explained: 

“We found that patients that experience early cancer relapse have higher stress hormone levels and neutrophil activation markers in their blood compared to patients that do not experience relapse, or experience relapse after longer time,” 

Dr. Perego emphasizes that stress by itself is not responsible for the relapse, but indicates that there is a chain of events that contribute. Dr. Perego notes that you need stress hormones AND neutrophils AND you need them to be activated AND they have to produce this lipid to turn the cells on. When treating mice with common heart medication called beta blockers, the dormant tumor cells failed to wake up. Beta blockers are known to block norepinephrine activity. 

The research is too early to make any concrete assumptions and this may not affect myeloma cells in the same way, but future research could target these lipids. In the short term, Dr. Perego suggests that monitoring neutrophil activity or stress hormone levels could be added to a list of labs that could potentially provide early insight about rising cancer levels. 

Telling yourself to chill out as a myeloma patient might not seem feasible (especially with all else that is going on in the world right now), but you can take proactive action every day (set new goals, exercise, eat right, meditate, pray, etc.) to reduce stress so your hormones levels stay in as much balance as possible. 

Editor's Note: 

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