This increase in cortisol levels is concerning as it has been well documented that cortisol promotes cancer progression via direct activity on tumor cells by activating glucocorticoid receptor (GR) signaling pathway, and upregulating downstream anti-apoptotic genes such as serum/ glucocorticoid-regulated kinase 1 (SGK1) and mitogen activated protein kinase phosphatase 1 (MKP1)/dual specificity phosphatase 1 (DUSP1) [54]. This evidence concerns the gene DUSP1 and neoplasm.