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“Don’t underestimate the level of meaning and importance” on a person’s stress management and overall wellbeing, said Susan Lutgendorf, Ph.D., to a crowded room of cancer investigators and community advocates. “It helps people to feel like they’re contributing to the world in some way and making a difference.”

It was just one talking point of many shared during a day-long symposium hosted by VCU Massey Comprehensive Cancer Center on the connections between stress and cancer.

Hundreds of scientists, clinicians, students and community advocates gathered at the Science Museum of Virginia on March 26 for the 3rd annual Gordon Ginder Innovations in Cancer Symposium.

The conference, moderated by Massey researchers Autumn Lanoye, Ph.D., and Can Senkal, Ph.D., featured a wide range of discussions and presentations on various topics around stress and cancer, including primary care perspectives on the correlation between stress and chronic health conditions like cancer; the molecular effects of various stressors on the genetic makeup of younger cancer patients; effective cognitive behavioral stress management strategies in cancer survivors; among many others.

Allie Straus, a Ph.D. student in Senkal’s lab, gave an introductory presentation to open up the symposium, including an overview of some of the cellular stress responses that increase cancer risk over time, as well as a brief explanation of her own research investigating the role that sphingolipid metabolism plays in the development of stress and cancer.

“We [actually] harness…stress in order to treat cancer cells,” Straus explained of the goal of her work.

Alex Krist, M.D., M.P.H., member of the Cancer Prevention and Control research program at Massey, offered a family medicine perspective on stress and cancer during the conference.

“Who is stressed? The answer is everyone…It’s a natural physiological response. It can be a healthy thing,” Krist said. “The problem is when you have chronic or prolonged stress. It can have a negative effect.”

Krist elaborated on the multi-level impact of stress on people, their communities and their genes. He mentioned that Black women are twice as likely to have triple-negative breast cancer as white women, but evidence indicates that regional differences, not racial, are the cause, suggesting that environmental and social determinants cause this poor outcome.

“Stress physically impacts your genes, which can get passed on to the next generation,” Krist said.

Krist added that his research efforts are focused on using a patient-centered approach to primary care that addresses root causes of poor health to determine if that method can help people control chronic conditions more effectively than traditional medical care.

Elizabeth Repasky, Ph.D., Lawrence J. Minet professor of immunology at Roswell Park Comprehensive Cancer Center, gave a presentation on her research examining the molecular pathways by which stress influences antitumor responses. In particular, she investigates the use of temperature and mild thermal stress as a means to enhance the activity of immune cells in cancer models.

“Tumor growth is slower in mice housed at 30 degrees Celcius,” Repasky said. “[It’s] not a cure, but an interesting suppression of tumor growth.”

Additionally, Repasky said that data from her research findings may contribute to the understanding of how chronic stress leads to more aggressive cancers in patients and to the identification of novel immune biomarkers in patients in need of greater stress-reducing interventions.

David Tuveson, M.D., Ph.D., director of the Cold Spring Harbor Laboratory Cancer Center, spoke about the biology and medicine of pancreatic cancer as it relates to stress.

He talked about efforts to establish more effective preventive methods and understand elevated risk for pancreatic disease; develop effective diagnostics and encouraging results for novel methods for early detection; and improve therapeutics for pancreatic cancer through predictive methods for enrollment on clinical trials and the treatment of systemic illness.

“I think there is going to be a lot of progress to be made here,” Tuveson said.

Joyce Ohm, Ph.D., chair of cancer genetics and genomics at Roswell Park Comprehensive Cancer Center, presented on the effects of molecular stressors on the epigenome of adolescent and young adult cancer patients.

Some of her research looks at Ewing sarcoma in children and young adults, and mitigating the impact of genetic replication stress on cancer growth through the use of novel therapeutics.

Ohm highlighted the scientific assertion that stressors are cumulative across the lifespan and that leads to cumulative changes in the epigenome as well.

“We can start to answer the questions that many of us have been asking for so long,” Ohm said, adding that advancements in technology have significantly enhanced her research efforts. “Stress may actually be a therapeutic vulnerability in some settings, and we need to expand that more moving forward.”

Lutgendorf, a research member at the Holden Comprehensive Cancer Center, presented on the biology of stress and resilience in cancer and applying that understanding to psychosocial interventions for therapeutic benefit.

On a cellular level, her lab looks at the relationships between behavioral risk factors — such as social anxiety, chronic stress, depression and social isolation — and the immune response in tumors.

“There is a constant interplay between stress and the niche that cancer cells operate in,” Lutgendorf said.

She highlighted an ongoing multi-site clinical trial for web-delivered group intervention strategies to reduce stress in ovarian cancer patients, including relaxation, meditation and healthy lifestyle techniques.

Frank J. Penedo, Ph.D., director of cancer survivorship and supportive care at the Sylvester Comprehensive Cancer Center, joined the event virtually to talk about cognitive behavioral stress management in prostate cancer survivors.

“Stressful experiences are prevalent, under detected and undertreated,” Penedo said.

Penedo commented on his work to identify unmet needs in Hispanic/Latino prostate cancer survivors and how to determine the most effective way to convey information to patients, spouses and caregivers to help lessen stress and associated risk factors.

The symposium culminated in a panel discussion between all of the featured speakers to elucidate future solutions for addressing the burden of stress and cancer.

The symposium is named for Gordon D. Ginder, M.D., who held the Lipman Chair in Oncology and served as director at Massey from 1997 to 2019, and continues contributing to research, patient care and education at the cancer center as a physician-scientist.

“Thank you for reflecting the best of Massey, and laying the foundation for what we do,” said Massey director Robert A. Winn, M.D., as he looked toward Ginder during closing remarks at the symposium.

Winn added: “It brings me great joy in understanding that, by way of honoring Dr. Ginder, we are bringing in the best science and the best scientists.”