BOSTON — A positive attitude is not likely to increase the chance of recovering from advanced cancer, contrary to popular belief, although it may make the course of the disease more bearable, researchers said Wednesday.
Researchers at the University of Pennsylvania studied 359 patients with advanced cancer and compared various social and psychological factors to the length of survival or time before recurrence of the disease.
They found factors such as job satisfaction, social ties, marital history and feelings of hopelessness had no effect on how long the patient lived or how long it took for the disease to cause a relapse.
"The biology of the disease appears to predominate and to override the potential influence of life style and psychosocial variables once the disease process is established," the report in the New England Journal of Medicine said.
Barrie R. Cassileth, director of psychosocial programs at the University of Pennsylvania Cancer Center, said that the study was conducted because of the common belief that cancer patients must have a positive attitude to survive.
"We're seeing, particularly in the cancer field, a lot of people who believe that, if people reduce stress and eat properly, they can cure cancers," Cassileth said. "If they don't recover, it's because they failed to think and eat properly.
"It imposes major guilt on the patient," she said.
Influence of Two Factors
The belief that overall attitude can influence recovery from severe cancer probably came from two factors, the researchers concluded. A number of studies have been published in the last few decades that showed a relationship between psychosocial factors and the cause or course of malignant disease. However, a review of the literature showed that those studies were contradictory and not well conducted.
The second reason for the belief is various studies of healthy persons, which show a significant relationship between mental health and longevity.
"Work satisfaction and happiness were found to predict longevity better than any health or physical-activity factor" in studies conducted by others, the report said.
In an editorial accompanying the study, Dr. Marcia Angell, the journal's deputy editor, wrote: "It is time to acknowledge that our belief in disease as a direct reflection of mental state is largely folklore."
This belief, she said, has made some persons feel that they are to blame for their illnesses because they lack the proper self-discipline or will to live.