• 11/13/2007
  • Eugene, OR
  • staff
  • Register-Guard (www.registerguard.com)

The popular image of cancer patients facing their condition with a mixture of defiance and determined optimism is so pervasive that oncologists sometimes refer to it as the “prison of positive thinking.”

“In the breast-cancer culture, cheerfulness is more or less mandatory, dissent a kind of treason,” journalist Barbara Ehrenreich wrote in Harper’s magazine after her own breast cancer diagnosis.

For better or for worse, the treason has been pardoned and those prison doors have been pried open by a University of Pennsylvania research team. A study led by psychologist James Coyne that will be published in the December issue of the journal Cancer concludes that emotional well-being had no effect on overall cancer survival rates.

But if previous reaction to similar findings is any indication, many prisoners of positive thinking will elect to remain in their cells. There’s really nothing wrong with that, Coyne says. There can be lots of emotional and social benefits to taking a positive approach as long as it isn’t tied to an expectation that it actually enhances cancer survival.

The real downside of the “live strong, think positive” mantra is that when cancer patients experience the normal cycles of sadness, depression and self-pity, they exaggerate the consequences. They feel weak and defeated, and fear they’re letting their loved ones down. Even worse, they feel they may actually be reducing their chances of survival. Depression equals death.

Coyne’s study is the largest ever to focus specifically on the relationship between emotional well-being and cancer survival. Emotional well-being was measured with five questions on a quality of life questionnaire that asked patients whether they felt sad, were losing hope, feeling nervous and worrying about dying, worrying that their condition would worsen, and whether they were proud of how they were dealing with their condition.

The researchers studied responses from almost 1,100 head and neck cancer patients, 646 of whom died, giving Coyne’s team one of the largest statistical samples ever analyzed.

The conclusion that emotional factors aren’t linked to survival underscores that cancer is a biological disease process that patients have little control over. It may do patients a world of good on an emotional level to “live strong and think positive,” but it has no measurable effect on cancer cells.

A cancer diagnosis is life-altering, and one of the first and most natural responses is, “What can I do to improve my odds for survival?” It’s an effort to regain control of an overwhelming and bewildering set of circumstances.

Coyne’s findings ought to be seen as a blessing for cancer patients, freeing them of a misplaced sense of responsibility for the progression of their disease. The fear that negative emotions may be physically damaging can, by itself, be emotionally draining. Coyne’s research indicates patients should feel free to direct that energy elsewhere in their response to a cancer diagnosis.