Anger

Anger and Cancer: Is There a Relationship?

Intense, persistent, and suppressed anger may have a connection to cancer.

Posted Sep 18, 2017

Jacqueline Song
Source: Jacqueline Song

Anger is a negative emotion that can follow frustration, disappointment, and injustice. It can vary from mild and short-term to intense and long-term. It is the latter, the intense and long-term variety, that concerns us here, what we have called unhealthy anger (Enright & Fitzgibbons, 2015).

To begin answering the question concerning the link between anger and cancer, let us start with a quotation that may be an overstatement and then let us get more precise. Groer, Davis, Droppleman, Mozingo, and Pierce (2000) made the following general statement: “Extremely low anger scores have been noted in numerous studies of patients with cancer. Such low scores suggest suppression, repression, or restraint of anger. There is evidence to show that suppressed anger can be a precursor to the development of cancer, and also a factor in its progression after diagnosis.” Notice that their conclusion centers on a certain type of anger, that which is not overtly expressed but instead, to use a common expression, is bottled up.

Dreamstime / Katarzyna Bialasiewicz
Source: Dreamstime / Katarzyna Bialasiewicz

Our next question, then, is to look for supporting evidence of this claim of suppressed anger relating to cancer, and we find it in the early study by Greer and Morris (1975). In a sample of 160 women, they report a statistically-significant relationship between what they call extreme suppression of anger and breast cancer. Notice that the suppression of the anger is not a normal kind of restraint, but instead is extreme in rarely, if ever, being vented. This relationship might be caused by the cancer itself in that people get angry because of the diagnosis. Yet, in another early study, Pettingale, Greer, & Tee (1977) followed 160 women over a two year period prior to a diagnosis of cancer and subsequently after the diagnosis was made. They found that those with breast cancer (even before the diagnosis was made) who “habitually suppressed anger” had longitudinal patterns of increased serum Immunoglobulin A levels (implicated in some autoimmune diseases) compared to those who did not suppress their anger.

We need to ask, based on the above, whether it is certain kinds of cancer that are connected with anger or whether we have a general trend. One observation comes from Boerma (2007) as cited in Hendricks, Vore, Aslinia, & Morriss (2013), in which unhealthy anger is implicated in immune system compromise in general: "Anger also causes the release of the stress hormone, cortisol. Release of this hormone gives the body bursts of energy. However, too much of this hormone can cause a multitude of negative effects on the body. Too much cortisol in the body can cause an imbalance in blood sugar; it can suppress thyroid function, and decrease bone density. This hormonal imbalance also impacts the body’s immune system. Research shows that chronic-angry people suffer more frequent colds, flu’s infections, asthma, skin disease flare-ups and arthritis, as compared to non-chronic-angry people (Boerma, 2007)."

If the immune system can be compromised in some people who harbor unhealthy anger (intense and over long periods), then there may be a more general link between this form of anger and cancers. Yet, in a large (over 19,000) study over 9 years, there was no connection between reported levels of anger and breast cancer. There was, however, a small and statistically-significant relationship with prostate, lung, and colorectal cancers (White, English, Coates, Lagerlund, Borland, et al., 2007). We must be cautious with these findings for our purpose here because the anger assessment only concerned whether or not that anger was expressed or not. There was no measure of the intensity or longevity of the anger.  Their measure of negative affect included different kinds of emotions, not just anger. The association of suppressed anger in particular and prostate cancer is discussed in Penedo, Dahn, Kinsinger, Antoni, Molton, et al. (2006). These researchers report a stronger presence of the natural killer cell cytotoxicity (NKCC) when anger was not suppressed in a sample of 61 men.

To date, there are remarkably few studies of the anger and cancer link. The research to date does suggest a link, particularly with regard to intense and persistent anger that is suppressed. That link to date does not suggest a general association between suppressed anger and all types of cancers, but may be implicated in certain cancers such as breast cancer (although the findings are not consistent), and prostate, lung, and colorectal cancers. Perhaps it is time for both medicine and psychology to unite in a new angle in the fight against certain cancers by continuing to examine the anger-cancer link. If the findings as above continue, we need to find ways of reducing anger in particular when it is intense, abiding, and not expressed. This may be part of a regimen for cancer prevention, at least for certain kinds of cancers and for people who have a family history of these.

References

Boerma, C. (2007).  Physiology of anger.  Retrieved from http://healthmad.com/mental-health/physiology-of-anger/

Enright, R.D. & Fitzgibbons, R. (2015). Forgiveness therapy.  Washington, DC: APA Books.

Greer, S. & Morris, T. (1975).  Psychological attributes of women who develop breast cancer: A controlled study.  Journal of Psychosomatic Research, 19, 147-153.

Hendricks, L., Bore, S., , Aslinia,D., & Morriss, G. (2013). The effects of anger on the brain and body. National Forum Journal of Counseling and Addiction, 2, 1-12.

Penedo, F.J., Dahn, J.R., Kinsinger, D., Antoni, M.H., Molton, I., et al. (2006).  Anger suppression mediates the relationship between optimism and natural killer cell cytotoxicity in men treated for localized prostate cancer.  Psychosomatic Research, 60, 423-427.

Pettingale, K.W., Greer, S., & Tee, D.E. (1977). Serum IgA and emotional expression in breast cancer patients. Psychosomatic Research, 21, 395-399.

Thomas, S.P., Groer, M., Davis, M., Droppleman, P., Mozingo,J., & Pierce M. (2000), Anger and cancer: an analysis of the linkages.  Cancer Nursing, 23, 344-349.

White, V.M., English, D.R., Coates, H., Lagerlund, M., Borland, R., et al. (2007). Is cancer risk associated with anger control and negative affect? Findings from a prospective cohort study. Psychosomatic Medicine, 69, 667-674.