Does keeping a positive mental outlook help cancer patients to live longer?
People who are depressed about their cancer are no more likely to die than people who keep a positive outlook, U.S. researchers reported on Monday.
The choice of medical reports that news services choose to disseminate continues to fascinate me, including this latest bit of research involving 1100 patients with locally advanced cancer of the head and neck area. I’m sure they picked this story because of the popular conception that those who keep a positive outlook when fighting cancer will have a better outcome. If one believes this then all the more thrilling for news editors when thousands of gasps are released over such headlines as “Positive Attitude Does Little to Boost Cancer Survival Odds, Study Says’.
Are they telling us that all this “keep your head up” advice given to cancer patients is worthless?
The researchers looked at pooled quality-of-life data for head and neck cancer patients receiving concurrent chemotherapy and radiation therapy and found the following:
Emotional well-being at baseline in the studies was measured with five questions on the FACT-G quality of life questionnaire evaluating whether patients felt sad, were losing hope, feeling nervous, worrying about dying, worrying that their condition would worsen, and whether they were proud of how they were dealing with their condition.
In univariate analysis, well-being was not associated with survival…Nor did well-being impact survival in multivariate analysis accounting for study protocol, demographics, smoking, cancer stage, and performance status…None of the exploratory subgroup analyses for study protocol, gender, primary tumor site, and cancer stage showed a significant effect of emotional state on survival. Addition of all the interactions to well-being did not improve association either.
The authors conclude that despite a widespread belief among doctors and patients that a strong sense of emotional well-being can improve survival in people living with cancer, multiple studies including this one refute such claims. Wrote the authors, “The belief that emotional well-being affects survival, nonetheless, has been remarkably resilient in the face of contrary data.”
Anyone who has known a head and neck cancer patient might have reached this conclusion even without having read the story. In fact, they might just say, “You needed to collect quality-of-life surveys to figure this out? Have you ever seen what treatment for head and neck cancer does to you? The biggest surprise in your study is finding patients who weren’t depressed.” As a medical oncologist, I understand what our commenter is implying, viz., head and neck tumors are grievous and require particularly harsh treatment in order to eradicate them.
Nevertheless, I strongly support the sowing of hope and joy in the lives of my patients. The research data show that it won’t make them live any longer than if they were depressed. I understand, and won’t suggest that they will live a longer life with such an attitude – just a better one.
A happy life consists not in the absence, but in the mastery of hardships.