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Does stress effect the effectiveness of tyrosine-kinase inhibitors?

I was diagnosed with Chronic myeloid leukaemia in October 2014, and have been taking nilotinib (Tasigna), and have had an excellent response, nearly reaching the one year optimal result level in three months. Prior to my diagnosis I was an extremely ambitious high flyer in my career. I took three months off sick, and have now returned to work. However, I am concerned – and this is my question to the forum – would workplace stress effect the effectiveness of tyrosine-kinase inhibitor like nilotinib? I wish to resume pushing ahead with my career – but with this comes stress – and I am frankly scared that this stress will make the drugs less effective and end up killing me? Is this misplaced paranoia, or it is a factual concern?

Many thanks for any help.

Hello,

I'm in a similar position, but a little further down the line. I was pushing hard on the career ladder when diagnosed at 32 (4 years ago). I then pulled back a bit and took it slow for a few years - stayed at same grade etc. After a few years and an acceptably low and sustained PCR response I'm back on the ladder and back in a stressful and very demanding position. As for results, so far so good, however; there is a balance.

If i were to look after myself in a 100% beneficial way i.e. low stress, well balanced diet, adequate rest, adequate exercise, then I could confidently say that any adverse changes in PCR level were largely unavoidable and not influenced by lifestyle. My view is that every time I negatively impact my lifestyle through stress, diet, lack of exercise, then i'm increasing my risk of worse health in general. I am willing to take some of that risk in pursuit of financial security, professional fulfillment and reaching my true potential.

If after a while I found my PCR (or health in general) was taking a big impact I would reconsider my career choices and maybe slow it down. There is always is a balance to be had and it depends on the level of risk you're comfortable with.

Stress can do funny things to your health. One of my staff is struggling with the effects of stress and it's impacting their ability to work, home life and overall health. Would stress directly impact TKIs? - probably not. Would stress impact your general health? - probably, and your health has been impacted by CML.

So, for me it's all about finding that balance of demanding and successful career and not sending me to an early grave. It's a risk i'm happy to take right now, but that my change if my health becomes noticeably worse.

Chris

Thank you for your response. I am 31 and do not want cml to define how I should live my life because the way I see it is that TKI have given me another chance in life. I will however do my best to balance work and home life without losing sight of what is important to me which is my family and my health.

Cheersx

...I was dx in Feb 2012, in the middle of a difficult divorce process which went on over a year, large change in friendship circles, significant family issues, moved home twice within 2 years, spent a number of months unemployed followed by a fairly stressful new role with a client that required multi-day foreign travel on a weekly basis.

I've restarted snowboarding, scuba diving, intensive hiking, working out at the gym and still drink and eat whatever I want (within reason).

I've still hit MMR in around 24 months and seem to be remaining there despite constant high levels of stress.

For those for whom TKIs work, your life doesn't have to change in any way whatsoever, it's up to you how you let it affect you - for me it was a boost to get things done in life!

Rod

20 years next month from diagnosis . Of course that was the early days when diagnosis was a death sentence and treatment was really tough!

I've had a matched unrelated bone marrow transplant and then 4 years after that went on imatanib in clinical trial.

I've had 4 goes at being told "prepare for the worst" and come through and survived to have the wonderful opportunity of just taking a few tablets of glyvec... And some other stuff because of side effects and consequences of early treatment.

Live life to the full. Do what you want to do. What fulfills you.

I've often said that I think I might be afraid of dying but I sure as hell aren't afraid of living.

If something is stressing you in a way that's negative then you might need to learn some techniques to manage it better. Stress in itself is never a problem. It's how you meet and manage it.