慢性压力通过神经内分泌系统干扰身体激素的平衡。癌症患者在疾病进展和治疗过程中经常经历反复的焦虑和不安，这加重了疾病的进展并妨碍了治疗效果。最近的研究表明，慢性压力调节神经内分泌系统分泌激素以激活与肿瘤发展相关的许多信号通路。激活的神经内分泌系统不仅作用于肿瘤细胞，而且调节周围非癌变细胞的生存和代谢变化。当前的临床证据还表明，慢性压力会影响癌症治疗的结果。然而，在临床上，癌症患者慢性压力缺乏有效的治疗方法。在本综述中，我们讨论慢性压力调节肿瘤微环境的主要机制，包括应激激素对肿瘤细胞功能的调节（干细胞样的特性、转移、血管生成、DNA损伤积累和凋亡抵抗）、代谢重编程和免疫逃逸以及周围神经调节。基于当前的癌症和慢性压力的临床治疗框架，我们也总结了药物和非药物治疗方法，为癌症治疗提供一些方向。©2023。作者。

Chronic stress results in disturbances of body hormones through the neuroendocrine system. Cancer patients often experience recurrent anxiety and restlessness during disease progression and treatment, which aggravates disease progression and hinders treatment effects. Recent studies have shown that chronic stress-regulated neuroendocrine systems secret hormones to activate many signaling pathways related to tumor development in tumor cells. The activated neuroendocrine system acts not only on tumor cells but also modulates the survival and metabolic changes of surrounding non-cancerous cells. Current clinical evidences also suggest that chronic stress affects the outcome of cancer treatment. However, in clinic, there is lack of effective treatment for chronic stress in cancer patients. In this review, we discuss the main mechanisms by which chronic stress regulates the tumor microenvironment, including functional regulation of tumor cells by stress hormones (stem cell-like properties, metastasis, angiogenesis, DNA damage accumulation, and apoptotic resistance), metabolic reprogramming and immune escape, and peritumor neuromodulation. Based on the current clinical treatment framework for cancer and chronic stress, we also summarize pharmacological and non-pharmacological therapeutic approaches to provide some directions for cancer therapy.© 2023. The Author(s).