From Our 2007 Archives

Attitude Doesn't Affect Cancer Survival

Study Shows Positive Thinking by Patient Has No Impact on Surviving Cancer

By Salynn Boyles
WebMD Health News

Reviewed By Louise Chang, MD

Oct. 22, 2007 -- 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."

SOURCES: Coyne, J.C. Cancer, Dec. 1, 2007; vol 110: online edition. James C. Coyne, PhD, department of psychiatry, University of Pennsylvania Health System, Philadelphia. Jimmie Holland, MD, Memorial Sloan-Kettering Cancer Center, New York City. Coyne, J. Psychological Bulletin, 2007; vol 133: no. 3.

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