Prolonged Psychological Conflicts and Their Contribution to Cancer Onset and Treatment Responsiveness: An Integrative Narrative Review

Psychological trauma and chronic stress are increasingly acknowledged as relevant contributors to the onset and progression of somatic illness, including cancer. This integrative narrative review examines the potential role of prolonged and unresolved psychological conflicts, such as early-life adversity, toxic relational dynamics, chronic grief, and emotional invalidation, in modulating oncological vulnerability. Drawing from the fields of psycho-oncology, psychoneuroimmunology, and developmental psychopathology, we outline the psychobiological mechanisms through which chronic stress may impair immune surveillance, dysregulate the hypothalamic–pituitary–adrenal (HPA) axis, and promote low-grade systemic inflammation. These alterations can increase susceptibility to oncogenic infections (e.g., persistent Human Papillomavirus (HPV), reduce the body’s capacity to repair cellular damage, and contribute to tumorigenesis. We further discuss how trauma-related disorders, including posttraumatic stress disorder (PTSD), may negatively affect treatment adherence, reduce responsiveness to chemotherapy and immunotherapy, and increase cancer recurrence risk. Moreover, we introduce the model of trauma–cancer–retraumatization, highlighting how a cancer diagnosis can both reactivate unresolved psychological trauma and amplify emotional distress. Empirical studies suggest that trauma-informed psychotherapeutic interventions targeting emotional processing, attachment security, and perceived agency may improve both psychological well-being and clinical outcomes in oncology patients. Based on this evidence, we recommend integrating systematic screening for adverse childhood experiences (ACEs) and trauma history into cancer care pathways. Recognizing and addressing the hidden burden of psychological conflict in oncology may support a more holistic approach to cancer prevention, treatment, and survivorship.