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Debi Fischer is a nurse at the University of Miami surgical oncology step down unit. Prior to that she worked in orthopedics and neurology for many years. In addition to her nursing experience, she has earned a master’s degree in social work. Becoming a Licensed Clinical Social Worker was a long sought after goal which she finally attained. She is a caregiver for her family and her dogs as well.

Ways for Nurses to Reduce Stress-Related Ulcers, Potential Gastric Cancer Risk

There are things oncology nurses can do to reduce their risk of gastric ulcers, and potentially, gastric cancer.
PUBLISHED: 6:42 PM, FRI AUGUST 3, 2018
Oncology nursing is a stressful profession. Coping with sick and dying patients can take a toll, and workplace factors can raise stress levels as well, contributing to anxiety and depression.

A study presented at the 2018 American Society of Clinical Oncology meeting measured anxiety and depression among 73 oncology nurses from 7 hospitals.1 Using the Hospital Anxiety and Depression (HAD) scale, researchers found that anxiety occurred in 31.5% of oncology nurses studied.1 They cited the reality of facing death daily as a factor contributing to their anxiety. Other factors were shift work, difficult patient assignments, and the inability to influence what happens on their units.1

A 10-year study of adults with anxiety disorders showed that anxiety can increase stomach acid secretion, raising the chances of developing a gastric ulcer.2 Current data show that half a million people are diagnosed with gastric ulcers annually in the United States, and nearly 5 million people suffer from them at any given time.2

Nurses who experience extreme levels of anxiety are at risk of developing gastric ulcers—which could develop into stomach cancer in certain individuals. For example, people who have had part of their stomach removed to treat non-cancerous diseases like ulcers may produce less acid, which in turn, would allow for an increase in nitrite-producing bacteria in the organ. However, of note, these cancers do not develop until many years later.3

Food for Thought

Because anxiety can be a contributing factor in the development of gastric ulcers, which is associated with an increased risk for gastric cancers, anxious nurses should take steps to modify their stress levels. The 10-year gastric cancer study suggests approaches such as meditation, breathing exercises, and other modalities to promote relaxation.2

In addition to traditional yoga and meditation classes, new calming technological solutions are being developed. A web-based program called “BREATHE: Stress Management for Nurses” was the subject of a 2016 randomized study that tested a web-based program that provided stress management techniques.4 One hundred and four nurses from 6 hospitals participated. The nurses who participated experienced significantly greater reductions than the control group on 6 of the 7 subscales on the Nursing Stress Scale.4 Another study recently tested the use of a meditation app for oncology nurses.5 Results showed that using the app significantly improved interoceptive awareness, and reduced compassion fatigue and burnout.   

Other Ways to Reduce Risks

Nurses who suffer from anxiety can take steps to protect themselves from related gastric health complications. Managing stress is one. Managing lifestyle contributors is another.

Helicobacter (H.) pylori, a treatable bacteria, has been implicated in causing gastric cancer.3 The good news is, antibiotics can eliminate H. pylori.1,2 However, if someone has a lengthy H. pylori infection they may develop an inflammation called chronic atrophic gastritis. They can also develop pre-cancerous changes in the abdomen.2 Foods high in nitrates and nitrites are known to contain the bacteria¾for example, cured meat such as hot dogs, bacon, and ham, salted fish, and pickled vegetables have been identified as sources.3 Curtailing intake of these foods would reduce the risks associated with gastric cancer from these sources. Incorporating fresh fruit and vegetables into one’s diet can reduce the risk of gastric cancer as well.

Smoking also raises one’s risk of gastric cancer. Smokers tend to get gastric cancer at double the rate of nonsmokers. A previous study on health professionals and smoking reported that, although the number of nurses who smoke was trending sharply down, survey results from 2010-2011 showed that approximately 25% of licensed practical nurses were considered current smokers.6

Bottom line: There are things oncology nurses can do to reduce their risk of gastric cancer. Managing stress and anxiety, ceasing to smoke, and modifying diet can have an impact on nurses’ cancer risk, not to mention their overall well-being. 
 
References
  1. Depression and anxiety in oncology nurses. J Clin Oncol. 36, 2018 (suppl; abstr e18552). abstracts.asco.org/214/AbstView_214_230907.html. Published May 16, 2018. Accessed July 24, 2018. 
  2. Taha, F., Lipsitz, J., Galea, S. Demmer, R., et al. Anxiety disorders and risk of self-reported ulcer: a 10-year longitudinal study among US adults. General Hospital Psychiatry. 2014; 36 674–679 doi: 10.1016/j.genhosppsych.2014.07.005.
  3. American Cancer Society. Stomach Cancer Risk Factors. American Cancer Society website. Published 2018. cancer.org/cancer/stomach-cancer/causes-risks-prevention/risk-factors.html.  Accessed July 24, 2018.
  4. Hersch, R, Cook, R, Deitz, D, Kaplan, S, et al. Reducing nurses' stress: A randomized controlled trial of a web-based stress management program for nurses. Appl Nurs Res. 2016; 32 18-25 doi: 10.1016/j.apnr.2016.04.003.
  5. Lehto RH, Heeter C, Allbritton M, Wiseman M. Hospice and palliative care provider experiences with meditation using mobile applications. Oncol Nurs Forum. 2018;45(3):380-388. doi: 10.1188/18.ONF.380-388.


Talk about this article with nurses and others in the oncology community in the General Discussions Oncology Nursing News discussion group.
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