Nature Reviews Cancer 6, 240-248 (March 2006) | doi:10.1038/nrc1820

OpinionThe influence of bio-behavioural factors on tumour biology: pathways and mechanisms

Michael H. Antoni1, Susan K. Lutgendorf2, Steven W. Cole3, Firdaus S. Dhabhar4, Sandra E. Sephton5, Paige Green McDonald6, Michael Stefanek6 & Anil K. Sood7  About the authors


Epidemiological studies indicate that stress, chronic depression and lack of social support might serve as risk factors for cancer development and progression. Recent cellular and molecular studies have identified biological processes that could potentially mediate such effects. This review integrates clinical, cellular and molecular studies to provide a mechanistic understanding of the interface between biological and behavioural influences in cancer, and identifies novel behavioural or pharmacological interventions that might help improve cancer outcomes.

Author affiliations

  1. Michael H. Antoni is at the Departments of Psychology, Psychiatry, and Behavioural Sciences and the Sylvestor Cancer Center, University of Miami, P.O. Box 248185, Coral Gables, Florida 33124, USA.
  2. Susan K. Lutgendorf is at the Departments of Psychology and Obstetrics and Gynecology and The Holden Comprehensive Cancer Center, University of Iowa, E11 Seashore Hall, Iowa City, Iowa 52242, USA.
  3. Steven W. Cole is at the Division of Hematology–Oncology, University of California, Los Angeles School of Medicine 11-934 Factor Building, Los Angeles, California 90095-1678, USA.
  4. Firdaus S. Dhabhar is at the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Office 2325, Stanford, California 94305, USA.
  5. Sandra E. Sephton is at the Department of Psychological and Brain Sciences, James Graham Brown Cancer Center, University of Louisville, 2301 South 3rd Street, Room 317, Louisville, Kentucky 40202, USA.
  6. Paige Green McDonald and Michael Stefanek are at the Basic and Biobehavioural Research Branch, Behavioural Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, 6130 Executive Boulevard, MSC 7363, Bethesda, Maryland 20892, USA.
  7. Anil K. Sood is at the Departments of Gynecologic Oncology and Cancer Biology, University of Texas M. D. Anderson Cancer Center, Unit 1362, P.O. Box 301439, Houston, Texas 77230-1439, USA.

Correspondence to: Paige Green McDonald6 Email:


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