Stress, inflammation, and resilience among patients with oral squamous cell carcinoma undergoing multimodal therapy: Current knowledge and future directions.

Patients with oral cancer face tremendous physical and emotional stress during treatment with surgery, radiation, and chemotherapy. Researchers reviewed how this stress affects the body's inflammation levels and why some patients recover better than others. They found that chronic stress activates the body's fight-or-flight response, raising stress hormones like cortisol and inflammatory markers such as interleukin-6 and C-reactive protein. This can worsen tumor growth, make treatments harder to tolerate, and increase heart disease risk. The good news is that resilience—the ability to bounce back emotionally and physically—can help protect against these harmful effects. The study identified several promising approaches to reduce stress and inflammation during cancer treatment. Psychological support through counseling, cognitive-behavioral therapy, and peer mentoring helped reduce anxiety and improve treatment adherence. Quitting smoking and betel quid chewing (common in Asia) lowered inflammation significantly. Importantly, acupuncture emerged as a valuable non-drug option that helps rebalance the nervous system and reduce inflammation while avoiding opioid dependence. Other complementary approaches like mindfulness meditation and vagus nerve stimulation also showed benefits. Nutritional strategies including omega-3 supplements helped preserve muscle mass and reduce inflammatory responses. The researchers noted that combining these interventions with standard cancer care may improve both cancer outcomes and heart health. Technologies like heart rate monitoring can help track stress levels in real-time, allowing personalized adjustments to supportive care. For oral cancer patients considering acupuncture as part of their supportive care, this research suggests it may help manage treatment-related symptoms while supporting the body's natural healing responses. Seek treatment from a licensed acupuncturist experienced in oncology supportive care.

This comprehensive review examines stress-inflammation-resilience interactions in oral squamous cell carcinoma patients undergoing multimodal therapy, with particular focus on Asian populations. Chronic sympathetic-adrenal-medullary and hypothalamic-pituitary-adrenal axis dysregulation elevates catecholamines, cortisol, IL-6, and CRP, promoting tumor progression and cardiovascular morbidity. No specific sample sizes or effect sizes are provided as this is a narrative review rather than primary research. Key interventions identified include structured psychoeducation, CBT, and peer mentoring for anxiety reduction and adherence. Acupuncture is specifically highlighted alongside transcutaneous vagus nerve stimulation and mindfulness as nonopioid modalities that recalibrate neuro-immune signaling. Enhanced recovery protocols and omega-3 supplementation attenuate systemic inflammation and preserve lean body mass. Heart rate variability and neutrophil-lymphocyte ratio show promise as real-time biomarkers. Clinical takeaway: Acupuncture represents an evidence-supported component of multimodal supportive care that addresses both neurophysiologic stress pathways and inflammatory cascades while minimizing opioid exposure in this high-risk oncologic population requiring cardio-oncology surveillance.