According to a new study of just over 1,000 cancer patients, the answer may be no.
Maintaining a positive outlook in one’s life may not make any difference to how long a person can survive after being diagnosed with the condition, according to a new US study. Earlier studies had documented attitude as having some probably impact in surviving cancer, but the present study says neither positive nor negative attitude affects survival in head and neck cancer patients.
According to the American Cancer Society, thousands of new cases of head and neck cancer are diagnosed annually. Among them 11,000 patients lose their fight against the cancer. It is generally thought that the mental state of the patient has an impact on the outcome of cancer.
Researchers from the University of Pennsylvania report that emotional l and social benefits are accrued if head and neck cancer patients enlist in a support group or even opt for psychotherapy. However if patients look to these experiences simply to prolong their life is not true, the study added.
The study examined data related to 1,093 patients who were enrolled in two Radiation Therapy Oncology Group (RTOG) trials. These trials were intended to test out innovative head and neck cancer treatments.
Patients from the clinical trials completed a quality of life questionnaire known as the Functional Assessment of Cancer Therapy-General (FACT-G) at the start of the trials. The FACT-G questionnaire includes 6 items that assess “emotional well-being” through questions like “I feel sad”, “I feel nervous,” “I worry about dying,” and “I worry that my condition will get worse.” This was assessed against overall survival.
The study lasted for five years during which 646 patients died. After analyzing their findings, researchers concluded that emotional state had no bearing on cancer survival.
There were two primary limitations of the study not mentioned in most mainstream media reports of the study, however.
The researchers apparently only assessed emotional state with a single data point at a single point in time. Since cancer treatment generally is conducted over a period of months, and mood varies with time, it’s possible the researchers did not obtain a broad enough time sample.
Second, some research has found that the reliability of the small 6-item emotional scale of the FACT-G is susceptible to how it is administered (e.g., Cheung et al., 2006; D’Antonio, 1998). Outside of the original validation studies published in 1993 and 1995, there has been little additional research into how robust a measure the emotional well-being component of the FACT-G is, especially when drawing such a significant conclusion such as this. There is no equivalent general 6-item mental health well-being scale in existence because emotional well-being is generally considered too complex to measure with only 6 items.
It should also be noted that the functional well-being subscale of the FACT-G also measures important social and psychological components of an individual’s life, with items such as “I am able to enjoy life,” “I have accepted my illness,” and “I am enjoying the things I usually do for fun.” Apparently the current study didn’t find a significant relationship between this subscale and morbidity, the only outcome measure used.
“The belief that emotional well-being affects survival, nonetheless, has been remarkably resilient in the face of contrary data. It is not clear what it would take to move the field beyond an appraisal of the literature even as simply ‘mixed’ or ‘contradictory,'” the authors write.
However they admit the outcome might be different in cancers like breast cancer and prostate cancer, which are hormone-influenced. But in head and neck cancer patients, a positive or a negative attitude is unlikely to make much of a difference.
In a separate review of other studies published earlier this year, James C. Coyne, PhD, 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.”
“I wish it were true that cancer survival was influenced by the patient’s emotional state,” Coyne told another health site. “But given that it is not, I think we should stop blaming the patient.”
The details of the study are published in the December 1 2007 issue of the journal Cancer.
Cheung YB, Goh C, Thumboo J, Khoo KS, Wee J. (2006). Quality of life scores differed according to mode of administration in a review of three major oncology questionnaires. J Clin Epidemiol, 59(2):185-91.
D’Antonio LL, Long SA, Zimmerman GJ, Peterman AH, Petti GH, Chonkich GD. (1998). Relationship between quality of life and depression in patients with head and neck cancer.