Objective
To explore the concept of allostatic load, the cumulative wear and tear on the body’s systems as a result of chronic stress responses, as a framework for understanding how chronic stress and trauma influence outcomes in individuals diagnosed with cancer.
Sample and settings
This presentation synthesises findings from an extensive body of interdisciplinary literature to describe the allostatic load model and demonstrate the relationships between trauma, stress, allostatic load and outcomes in diverse cancer survivor populations.
Procedures
Drawing on both primary research (qualitative and quantitative) and reviews, the session will narratively synthesise the existing evidence on allostatic load, cancer and health outcomes. Drawing on McEwan’s seminal and foundation studies, the presentation will describe the conceptual model of allostatic load and how allostatic load is operationalised. The growing body of evidence regarding allostatic load and cancer will then be used to explore and validate the model. Observational evidence will be summarised to demonstrate the relationships between trauma, stress, allostatic load and outcomes across different cancer survivor populations. Socioenvironmental stressors will also be explored.
Results
The experience of cancer is stressful, and for some individuals traumatic. Cancer-related stress and trauma (e.g. post-traumatic stress disorder) are associated with poor cancer-related outcomes. Early-life trauma is also associated with elevated allostatic load and poorer cancer-related outcomes. Individuals with high allostatic load exhibit poorer cancer-related outcomes including poorer quality of life and higher levels of treatment-related toxicities, cancer recurrence and mortality. Socioenvironmental stressors such as education level and adverse neighbourhood factors can impact allostatic load.
Conclusion and Clinical implications
The allostatic load model offers a robust conceptual and empirical framework for understanding how trauma and chronic stress impact cancer survivors. The framework can also aid our understanding of cancer health disparities. The allostatic load model provides valuable knowledge to underpin trauma-informed care practices.