Attitude Doesn't Affect Cancer Survival

Having a positive attitude may help cancer patients deal
with their disease, but it doesn't directly affect survival, according to one
of the largest and most rigorously designed investigations ever to examine the
issue.

The study included more than 1,000 people treated for head and neck cancer;
the emotional state of patients was found to have no influence on survival.

The findings add to the growing evidence showing no scientific basis for the
popular notion that an upbeat attitude is critical for "beating"
cancer, says University of Pennsylvania School of Medicine behavioral scientist
James C. Coyne, PhD, who led the study team.

"I wish it were true that cancer survival was influenced by the
patient's emotional state," he tells WebMD. "But given that it is not,
I think we should stop blaming the patient."

'The Tyranny of Positive Thinking'

Jimmie Holland, MD, agrees. The Memorial Sloan-Kettering Cancer Center
psychiatrist is a longtime critic of the "mind over cancer" proponents
who tell patients they must stay positive to survive their disease.

In her book The Human Side of Cancer, Living with Hope, Coping with
Uncertainty, Holland coined the term "the tyranny of positive
thinking" to describe the belief.

"The idea that we can control illness and death with our minds appeals
to our deepest yearnings, but it just isn't so," she tells WebMD. "It
is so sad that cancer patients are made to believe that if they aren't doing
well it is somehow their own fault because they aren't positive
enough."

Holland does acknowledge the benefits of staying positive during cancer
treatment, and she is an advocate of techniques like relaxation, meditation,
support groups, and prayer to help patients cope with their disease.

But she says there is no credible evidence that positive thinking alone
directly influences tumor growth.

"People really want to believe this, so even very good studies like this
one probably won't change public thinking," she says. "But the
scientific community is getting the message."

Attitude and Cancer Survival

The newly published study included 1,093 patients with head and neck cancer
who completed quality-of-life questionnaires during their treatment.

Coyne says the study group was limited to patients with a single cancer who
had similar treatments to better assess the impact of state of mind on
survival.

A total of 646 patients died during the study follow-up. Even after
acounting for other variables that could affect survival, a patient's emotional
state was found to have no bearing on whether or not he or she lived or
died.

The study appears in the Dec. 1 issue of the American Cancer Society (ACS)
journal Cancer.

In a separate review of other studies published earlier this year, Coyne,
University of Pennsylvania colleague Steven Palmer, PhD, and ACS researcher
Michael Stefanek, PhD, found insufficient evidence that participation in
psychotherapy or cancer support groups plays a role in survival.

In that report, the researchers concluded that the hope that emotional state
is a driving factor in cancer outcomes "appears to have been
misplaced."

"If cancer patients want psychotherapy or to be in a support group, they
should be given the opportunity to do so," they wrote in the journal
Psychological Bulletin. "There can be lots of emotional and social
benefits. But [patients] should not seek such experiences solely on the
expectation that they are extending their lives."

By Salynn Boyles
Reviewed by Louise Chang
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