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Lung Cancer & Stress- Mitigating This Underappreciated Risk Factor

Todd Robinson, ND, FABNO

November 3, 2020

Lung cancer is the third most common cancer in the United States and, in 2017 alone, a total of 221,121 new cases were reported in the U.S.1

November is lung cancer awareness month, so it’s a good time to explore how you can effectively reduce your risk of developing this common cancer type.

The first step to reducing risk is to understand it. Factors that are commonly known to increase lung cancer risk include smoking, secondhand smoke, radon gas, asbestos, and diesel exhaust.2 This makes sense as all of these are carcinogenic substances that are inhaled into the lungs.

An underappreciated risk factor for developing lung cancer is stress and multiple studies have found “stressful life events” increase this risk.3,4,5 This observation is consistent with basic science research demonstrating stress inhibits DNA repair, contributes to cancer progression and metastasis, and promotes cancer cell survival and treatment resistance.6,7,8

If you’d like to reduce your lung cancer risk, the first question to ask yourself is:  are you stressed?

This question, however, is highly subjective. Some of my clients claim not to be stressed, but their body is saying something different. The opposite happens too.

So how can you objectively assess your stress level?

Many validated questionnaires exist to assess your stress level. For instance, the Perceived Stress Scale is widely used and accurately reflects how much stress you’re under.9

You can also measure how your body is handling stress by looking at factors like:

  • Resting heart rate
  • Heart rate variability
  • Diurnal cortisol rhythm

Resting heart rate refers to how many times your heart beats in 60 seconds when you’re resting. Long periods of stress may result in an elevated resting heart rate10 and an elevated resting heart rate (≥75 bpm) has been shown to independently predict a poorer outcome in people already diagnosed with lung cancer.11

Heart rate variability refers to the time variation between heartbeats. Low heart rate variability reflects a high amount of stress, while high heart rate variability reflects a balanced stress response. There are multiple methods for assessing one’s heart rate variability and a high heart rate variability predicts a better prognosis for people diagnosed with cancer.12

Diurnal cortisol rhythm refers to the changes in your cortisol level (a stress hormone) over one day. Cortisol is supposed to peak in the morning (around 8 a.m.), decline over the day, and reach its low point around midnight. Chronic stress alters the cortisol curve, and such alterations in the cortisol curve have been shown to predict negative outcomes in people diagnosed with lung cancer.13,14

So if any or all of your evaluations reflect that you’re stressed and your body is having a hard time compensating for it, or if you want to prevent getting into that situation, what should you do?

One option is to work with a counselor. Evidence indicates working with a counselor decreases stress.15

Another option is to adopt a mindfulness practice. Mindfulness is defined as bringing your conscious awareness into the present moment. Meditation is probably the most common example of mindfulness practice. Mindfulness practices have been demonstrated to reduce perceived stress, symptoms of stress, anxiety, and mood disturbances in people diagnosed with cancer.16 As little as 5 minutes of meditation per day can help.

A third option is nature therapy. Nature therapy is defined as exposure to natural stimuli to foster physiologic relaxation. Walking in the forest or on the beach, gardening, and woodworking all count as nature therapy, and nature therapy has been demonstrated to reduce physiologic stress.17 Weekly nature exposure ranging from 30–120 minutes appears to be the minimum dose necessary for stress reduction.

And finally, a group of botanical medicines called “adaptogens” offer some interesting possibilities for modulating the body’s response to stress.18 For instance, one botanical adaptogen called Withania somnifera (ashwagandha) has been shown to reduce cortisol levels19,20, thereby improving the body’s response to stress.

You should always check with a knowledgeable professional before integrating any natural product into your regimen to ensure it is safe for your exact circumstances.

The take-home here is whether you’re concerned about reducing your risk of lung cancer or you’ve already been diagnosed with it, taking steps to assess your stress level and balance your body’s response to that stress can help.

Dr. Robinson owns and operates Natural Medicine Advisors. He offers telehealth consultations on the integration of natural medicine into any conventional treatment plan, be it for cancer or another medical condition.

Visit to learn more.


  1. CDC: Cancer Statistics
  2. CDC: Lung Cancer Risk Factors
  3. PMID: 11029995
  4. PMID: 18493231
  5. PMID: 31068757
  6. PMID: 23207104
  7. PMID: 21142861
  8. PMID: 29118262
  9. PMID: 2503113
  10. PMID: 12782748
  11. PMID: 27910284
  12. PMID: 29896113
  13. PMID: 22889441
  14. PMID: 22884416
  15. PMID: 29875530
  16. PMID: 21356643
  17. PMID: 27527193
  18. PMID: 33103257
  19. PMID: 23439798
  20. PMID: 31517876
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