Breast cancer is the most common cancer diagnosed in women. It is associated with multiple symptoms in both patients and caregivers, such as stress, anxiety, depression, sleep disturbance, and fatigue. Stress appears to promote cancer progression via activation of the sympathetic nervous system releasing epinephrine and norepinephrine as well as activation of hypothalamic-pituitary-adrenal axis releasing cortisol. These stress hormones have been shown to promote the proliferation of cancer cells. This review focuses on stress-reducing strategies which may decrease cancer progression by abrogating these pathways, with a main focus on the β-adrenergic signaling pathway. Patients utilize both non-pharmacologic and pharmacologic strategies to reduce stress. Non-pharmacologic stress-reduction strategies include complementary and alternative medicine techniques, such as meditation, yoga, acupuncture, exercise, use of natural products, support groups and psychology counseling, herbal compounds, and multivitamins. Pharmacologic strategies include abrogating the β2-adrenergic receptor signaling pathway to antagonize epinephrine and norepinephrine action on tumor and immune cells. β-Blocker drugs may play a role in weakening the pro-migratory and pro-metastatic effects induced by stress hormones in cancer and strengthening the anti-tumor immune response. Preclinical models have shown that non-selective β1/2-blocker use is associated with a decrease in tumor growth and metastases and clinical studies have suggested their positive impact on decreasing breast cancer recurrence and mortality. Thus, non-pharmacological approaches, along with pharmacological therapies part of clinical trials are available to cancer patients to reduce stress, and have promise to break the cycle of cancer and stress.

乳腺癌是女性中最常见的癌症。它与患者和护理人员的多种症状有关，例如压力、焦虑、抑郁、睡眠障碍和疲劳。压力似乎通过激活交感神经系统释放肾上腺素和去甲肾上腺素以及激活下丘脑-垂体-肾上腺轴释放皮质醇来促进癌​​症进展。这些应激激素已被证明可以促进癌细胞的增殖。本综述重点关注减轻压力的策略，这些策略可能通过消除这些途径来减少癌症进展，主要关注β-肾上腺素信号传导途径。患者利用非药物和药物策略来减轻压力。非药物减压策略包括补充和替代医学技术，例如冥想、瑜伽、针灸、锻炼、使用天然产品、支持小组和心理咨询、草药化合物和多种维生素。药理学策略包括废除β2-肾上腺素受体信号通路以拮抗肾上腺素和去甲肾上腺素对肿瘤和免疫细胞的作用。 β-受体阻滞剂药物可能起到减弱癌症中应激激素诱导的促迁移和促转移作用、增强抗肿瘤免疫反应的作用。临床前模型表明，非选择性 β1/2 受体阻滞剂的使用与肿瘤生长和转移的减少有关，临床研究表明它们对降低乳腺癌复发和死亡率具有积极影响。 因此，非药物方法以及临床试验中的药物治疗部分可用于癌症患者减轻压力，并有望打破癌症和压力的循环。