Pheochromocytoma and Stress
QUESTIONS AND ANSWERS
We received numerous questions regarding a possible link between a pheo and dramatic emotional stress. Therefore, we decided to consult with a top pheochromocytoma researcher for some answers. We discovered that there have been no studies, but we were given a good explanation of what is currently known with regard to stress being associated with a risk of developing medical disorders. Please read the email that was sent to our webmaster:
Subject: Stress Triggering Pheo?
Date: July 13, 2000
Although possible, it seems unlikely that periods of life stress would directly cause development of pheochromocytomas and I am aware of no literature to indicate this. HOWEVER, it is well established both in the lay- and scientific literature that severe or chronic life stress is associated with a higher risk of developing all kinds of medical disorders, including cancer or tumors. The most likely mechanism here is that such stress (severe-life event changes and chronic depression anxiety etc) results in activation of the hypothalamo-pituitary-adrenal cortical axis. This leads to higher levels of cortisol. Cortisol has immuno-suppressant properties and this may result in impaired surveillance by the immune system for aberrant mutated cells that have malignant potential.
There are many other possible hypotheses to account for the association of life-stress with disease. With regard to pheochromocytoma, for example, since adrenal steroids have direct influences on the development and phenotypic expression of adrenal medullary chromaffin cells one could hypothesize that increased cortisol might directly trigger chromaffin cell hyperplasia, leading to a pheochromocytoma. Thus although I say a direct link is unlikely it is theoretically possible, but this theory has not been pursued.
- Reference: Email correspondence between Dr. Graeme Eisenhofer of the National Institutes of Health, and Mary Peebels of the Pheochromocytoma Support Group