BMJ 2002;324:300 ( 2 February )

Letters

Widespread body pain and mortality

    Theories that psychological states cause cancer should be rejected
    Diagnosing fibromyalgia stops doctors from thinking

Theories that psychological states cause cancer should be rejected

The first 150 words of the full text of this article appear below.

EDITOR---In attempting to explain the finding that bodily pain is associated with excess mortality from cancer Macfarlane et al make reference to psychological theories of the aetiology of cancer.1 They claim that "the inability to release emotion" may "predispose people to the development of cancer." So why doesn't everyone in the United Kingdom have cancer? Why does Spain have higher rates of cancer than Japan? Why do Chileans have a comparable risk of cancer to the Chinese?

In support of their claim the authors cite a 20 year old review, as well as the work of Spiegel et al, whose randomised trial suggesting that psychological treatment aids survival from cancer2 has been repeated with negative findings. 3 4 More recent studies casting doubt on the links between psychological state and cancer are not cited.5 Simplistic theories suggesting that psychological states cause cancer are out of date and should be rejected.

Andrew Vickers, assistant attending research methodologist. 
Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, NY, NY 10021, USA vickersa@mskcc.org


1. Macfarlane GJ, McBeth J, Silman AJ. Widespread body pain and mortality: prospective population based study [with commentary by I K Crombie]. BMJ 2001; 323: 662-665[Abstract/Free Full Text]. (22 September.)
2. Spiegel D, Bloom JR, Kraemer HC, Gottheil E. Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet 1989; ii: 888-891.
3. Cunningham AJ, Edmonds CV, Jenkins GP, Pollack H, Lockwood GA, Warr D. A randomized controlled trial of the effects of group psychological therapy on survival in women with metastatic breast cancer. Psychooncology 1998; 7: 508-517[CrossRef][Medline].
4. Goodwin P, Leszcz M, Pritchard K, Arnold A, Navarro M, Chochinov H, et al. The breast expressive-supportive therapy (BEST) study: an RCT of the effect of group psychosocial support on survival in metastatic breast cancer (BC). Proc Am Soc Clin Oncol 2001; 20: 21(abstract).
5. Cassileth BR. Stress and the development of breast cancer: a persistent and popular link despite contrary evidence. Cancer 1996; 77: 1015-1016[CrossRef][Web of Science][Medline].

Diagnosing fibromyalgia stops doctors from thinking

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Relevant Article

Widespread body pain and mortality: prospective population based study • Commentary: An interesting finding, but what does it mean?
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