• 11/5/2007
  • Montreal, Quebec, Canada
  • Gerald Tatist et al
  • Montreal Gazette (www.canada.com/montrealgazette)

As health-care professionals in oncology, we wish to respond to The Gazette’s Oct. 29 editorial titled “Attitude in facing cancer: Let each person decide how to face cancer.”

In 1965, Dr. Franz Alexander wrote: “The fact that the mind rules the body is, in spite of its neglect by biology and medicine, the most fundamental fact which we know about the process of life.” Traditionally, medicine has focused primarily on the actual disease, not the person with the disease.

Attitude matters not because it might or might not prolong life, but because it makes life worth living. A sense of optimism can help patients cope with the many challenges and ramifications of dealing with this potentially life-threatening illness. A sense of resignation can make illness much more difficult to bear. Left unchecked, despair can also adversely affect compliance with treatment and may even lead to full-blown depression.

The editorial referred to the University of Pennsylvania study that followed patients with cancers of the head and neck. It concluded attitude did not affect survival rates. However, when you Google cancer survival and attitude, you will find another study on the role of patients’ attitudes in cancers of the head and neck, conducted by McGill University researchers, which describes positive predictive effects of dispositional optimism on survival.

So we have one study of many dismissing the value of optimism and another of many supporting the value of optimism. What is important is what patients actually tell us, and how we use this information to help others deal effectively with illness. When conducting research on the effectiveness of complementary therapies, we ask our patients if and how they are helping.

For example, one randomized, controlled clinical trial of newly diagnosed breast- and colon-cancer patients found patients who used Hope and Cope’s services scored much higher on measurements of optimism and psychological and functional well-being than those who did not use Hope and Cope.

Cancer patients and their families need to know at the outset they do not have to navigate this often terrifying journey alone. Health-care professionals have a responsibility to inform patients of the many options and resources available to them in the hospital system and in the community. In Montreal, we are very fortunate to be able to refer patients to organizations such as Hope and Cope and Cedars Can Support. We make these recommendations based on scientific evidence that describes the benefits of complementary therapies.

As pointed out in the editorial, the promising news is that positive lifestyle changes in terms of exercise and diet can reduce the risk of getting cancer. Encouraging cancer patients to exercise, both during and after treatment, and encouraging them to make positive dietary changes, might have a positive impact not only on quality of life, but also on disease progression.

The McGill Cancer Nutrition and Rehabilitation Program, with clinics at both the Royal Victoria and Jewish General hospitals, provides personalized nutrition counselling and individualized rehabilitation programs for patients suffering from loss of appetite, weight loss, increased fatigue and loss of function as a result of cancer.

Recognizing the importance of psycho-social support, oncologists throughout North America have begun integrating complementary therapies with traditional medical care. Dr. Stephen Sagar is one such expert whose careful consideration of his patients’ needs led him to become one of Canada’s leading champions of the importance of healing the body, mind and spirit.

Our collective experience in treating cancer patients and their families has taught us that patients place a high premium on quality of life and that complementary therapies and psyco-social support can go a long way towards enhancing their emotional, physical and spiritual well-being.

Authors:
Gerald Batist, Martin Chasen and Lynne McVey

Authors’ affiliations:
Gerald Batist is director of the Segal Cancer Centre at the Jewish General Hospital and chairman of oncology at McGill University;

Martin Chasen is clinical director of the McGill cancer nutrition and rehabilitation program at the Jewish General Hospital and McGill University Health Centre; Lynne McVey is director of nursing at the Jewish General Hospital and co-director of the Segal Cancer Centre.