Attitudes and Cancer
Emotions and feelings are an important part of coping with a cancer diagnosis. When a person is told they have cancer, questions like these may come up:
- Did I bring the cancer on myself?
- Can emotions really cause cancer to grow?
- Can I control the tumor growth by visualizing how my body is fighting the cancer or by thinking myself well?
- Would relaxation or keeping a “positive attitude” help cure my cancer?
Treatment that deals with our emotions and relationships (sometimes called psychosocial interventions) can help people with cancer feel more upbeat and have a better quality of life. But there isn’t good evidence to support the idea that these interventions can reduce the risk of cancer, keep cancer from coming back (prolong remission), or help the person with cancer live longer. Still, things like imagery, hypnosis, or relaxation can be used to help reduce the distress that often comes with a cancer diagnosis.
Personality traits and cancer
For many years there have been those who were convinced that people with certain personality types were more likely to get cancer. The common thought was that neurotic people and introverts were at the highest risk of cancer. Along with that, some believed that personality affected the outcome of cancer — the likelihood that a person with cancer might die.
Most of the study results on the subject tended to show no link between personality and cancer, but a few seemed to support the idea. Experts noted that many of these published studies were smaller, poorly designed, or not very well controlled. This means that their results were more likely to be due to bias or random chance. Also, some journals tended to publish the studies that suggested there was a link and reject those that showed no link. People are then more likely to read or hear about the few studies that seemed to show a link but not find out about those that didn’t show any link.
In 2010, the largest and best-designed scientific study to date was published. It looked at nearly 60,000 people, who were followed over time for a minimum of 30 years. This careful study controlled for smoking, alcohol use, and other known cancer risk factors. The study showed no link between personality and overall cancer risk. There was also no link between personality traits and cancer survival.
Does it help to keep a positive attitude?
People with cancer and their families may feel guilty about their emotional responses to the illness. They may feel pressure to keep a positive attitude at all times, which is unrealistic. This feeling of pressure can come from within themselves, from other people, or both. Sadness, depression, guilt, fear, and anxiety are all normal parts of learning to cope with major life changes, and a cancer diagnosis is a major life change. Trying to ignore these feelings or not talking with others about them can make the person with cancer feel lonely. It can also make the emotional pain worse. And some people feel guilty or blame themselves when they can’t “stay positive,” which only adds to their emotional burden.
Along these same lines, many people want to believe that the power of the mind can control serious diseases. This is a comforting belief that can make a person feel safer from the risk of serious illness. If it were true, you could use your mind to stop the cancer from growing. But the down side of such beliefs is that when people with cancer don’t do well, they may blame themselves.
To learn more about attitude and survival, researchers looked at the emotional well-being of more than 1,000 patients with head and neck cancer to find out whether it affected survival. Over time, those who scored high on emotional well-being showed no differences in cancer growth or length of life when compared to those with low scores. Based on what we know now about how cancer starts and grows, there is no reason to believe that emotions can cause cancer or help it grow.
Can psychotherapy help people live longer?
Research in the area of therapy, stress reduction, and cancer has come up with mixed findings. This can confuse reporters and patients alike. For example, a research study done in 1989 by David Spiegel and colleagues seemed to link a difference in survival with taking part in a support group. But other researchers who did the same kinds of studies did not have the same outcomes.
A 2004 study review pooled the results of many well-designed studies of cancer patients getting psychotherapy. With more than 1,000 patients in the final results, no effect was found on survival.
In 2007, other researchers looked at all the previous studies. They found that no randomized clinical trial set up to look at survival and psychotherapy has shown a positive effect, except in cases where medical care was a confounding factor. (This means that one group’s medical care could have been different enough to affect the results.)
Finally, Spiegel himself tried to repeat the 1989 study with a new group in 2007 to see if the result would be the same as that of their earlier trial. The 2007 study reported better quality of life among those who took part in the group, but there was no difference in survival.
In the last few decades, research has further shown that giving cancer patients information in a support group setting helps reduce tension, anxiety, and tiredness (fatigue), and may lower the risk of depression. Some other studies have shown that supporting cancer patients in keeping doctors’ appointments and teaching them about their treatment may help patients follow their treatment plan. While keeping doctors’ appointments and taking cancer treatment medicines as prescribed may help people live longer, this type of support is more medical and practical rather than mental health care.
It seems clear that support groups can affect quality of life, but the available scientific evidence does not support the idea that support groups or other forms of mental health therapy can help people with cancer live longer.
Mental health treatment and emotional support
Cancer affects your body, but it affects your emotions and feelings, too. Mental health treatment that claims to alter tumor growth is not recommended as the only form of cancer treatment, nor should it be sought just because someone thinks it might prolong life. But mental health care and emotional support can help patients and their loved ones better manage cancer and its treatment. Talk to the members of your cancer care team about things you can do to help yourself through a cancer diagnosis and treatment. Sometimes it also helps to talk to other survivors who are going through the same things you are facing.
Your attitudes, emotions, and moods can change from day to day, and even from hour to hour. You may feel good one day and terrible the next. Know that this is normal and that, with time, most people are able to adjust to a cancer diagnosis and move forward with their lives. Some may need extra help from a support group or a mental health professional to learn to cope better. Find the strength and support you need to feel the best you can and have the best possible quality of life.
If you would like to visit a support group or talk to someone about the life changes and emotions you are going through, ask your health care team about the resources you can use at your hospital, doctor’s office, or clinic. You can also contact your American Cancer Society at 1-800-227-2345 to find out about sources of support that are available near you.
To learn more
More information from your American Cancer Society
We have selected some related information that may also be helpful to you. These materials may be ordered from our toll-free number or you can read them online.
Living with cancer
After Diagnosis: A Guide for Patients and Families (also available in Spanish)
Coping With Cancer in Everyday Life (also available in Spanish)
Talking With Friends and Relatives About Your Cancer (also available in Spanish)
Learning About New Ways to Treat Cancer (Call us or visit our Web site for more on treatments used for different cancer types.)
Anxiety, Fear, and Depression (also available in Spanish)
If you know someone with cancer
Listen With Your Heart (also available in Spanish)
Questions People Ask About Cancer (also available in Spanish)
When Someone You Know Has Cancer (also available in Spanish)
When Someone You Work With Has Cancer (also available in Spanish)
No matter who you are, we can help. Contact us anytime, day or night, for information and support. Call us at 1-800-227-2345 or visit www.cancer.org.
Bennett KK, Compas BE, Beckjord E, Glinder JG. Self-blame and distress among women with newly diagnosed breast cancer. J Behav Med. 2005;28:313-323.
Boyles S. Positive Attitude Doesn’t Whip Cancer? Patients’ Positive Thinking Has No Impact on Cancer Survival, Study Shows. October 22, 2007, WebMD Web site. Accessed at www.webmd.com/cancer/news/20071022/positive-attitude-doesnt-whip-cancer on October 17, 2011.
Chow E, Tsao MN, Harth T. Does psychosocial intervention improve survival in cancer? A meta-analysis. Palliat Med. 2004;18:25-31.
Coyne JC, Pajak TF, Harris J, et al. Emotional well-being does not predict survival in head and neck cancer patients: a Radiation Therapy Oncology Group study. Cancer. 2007;110:2568-2575.
Coyne JC, Stefanek M, Palmer SC. Psychotherapy and survival in cancer: the conflict between hope and evidence. Psychol Bull. 2007;133:367-394.
Coyne JC, Tennen H. Positive psychology in cancer care: bad science, exaggerated claims, and unproven medicine. Ann Behav Med. 2010;39:16-26.
Holland JC. History of psycho-oncology: overcoming attitudinal and conceptual barriers. Psychosom Med. 2002;64:206-221.
Kissane DW. Letting Go of the Hope That Psychotherapy Prolongs Cancer Survival. J Clin Oncology. 2007;25:5689-5690.
Nakaya N, Bidstrup PE, Saito-Nakaya K, et al. Personality traits and cancer risk and survival based on Finnish and Swedish registry data. Am J Epidemiol. 2010;172(4):377-85.
Ranchor AV, Sanderman R, Coyne JC. Invited commentary: personality as a causal factor in cancer risk and mortality –time to retire a hypothesis? Am J Epidemiol. 2010;172(4):386-388.
Spiegel D, Bloom JR, Kraemer HC, et al: Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet. 1989;2:888-891.
Spiegel D, Butler LD, Giese-Davis J, et al. Effects of supportive-expressive group therapy on survival of patients with metastatic breast cancer: a randomized prospective trial. Cancer. 2007;110:1130-1138.
Last Revised: 10/28/2011