EDITOR - Petticrew et al summarise studies over several decades
showing that what cancer patients say about their attitudes to their
disease is not significantly related to survival outcomes. There is a
danger that this will be interpreted to mean that there is nothing these
people can do to help themselves live longer by psychological means. Such
a conclusion would be unwarranted from evidence that is confined to
administering self-report questionnaires at a single point in time. As in
other fields, what people say, under such conditions where socially
desirable responses are evident, is not nearly as important as what they
actually do. One would not, for example, assess the health value of
exercise solely by asking people whether they thought it was a good idea.
It is the impression of many clinicians engaged in helping cancer
patients help themselves with psychological and spiritual techniques that
becoming strongly involved with such methods and philosophies can indeed
make a difference to longevity in some cases. We have recently published
some evidence from a rigorous, correlative study on this question. One of
the difficult features of this research is that randomised controlled
trials are of limited applicability, since relatively few patients are
aware of, or motivated to make, the kinds of substantial mental changes
that appear to be needed to strengthen the body's cancer-regulating
mechanisms. Case by case analyses are thus required, to identify these
unusually motivated people. While the issue is certainly not resolved as
yet, it is important that we retain an open mind on the question of
educating patients to help themselves as a potentially valuable additional
resource in fighting serious chronic disease.
Alastair J Cunningham, PhD, C.Psych,
Senior scientist
Ontario Cancer Institute,
610 University Avenue,
Toronto, ON, M5G 2M9, Canada.
No competing interest
Petticrew M, Bell R, Hunter D. Influence of psychological coping on
survival and recurrence in people with cancer: systematic review. BMJ
2002; (9 Nov)
(Please note - pg #s not available from electronic copy)
Cunningham A J, Edmonds C, Phillips C, Soots K, Hedley D, Lockwood G.
A prospective, longitudinal study of the relationship of psychological
work to duration of survival in patients with metastatic cancer. Psycho-
oncology, 2000; 9: 323-339
Competing interests:
None declared
Competing interests:
No competing interests
19 November 2002
Alastair J. Cunningham
Senior Scientist
Ontario Cancer Institute, 610 University Ave., Toronto ON M5G 2M9, Canada
Rapid Response:
Mind and Cancer
EDITOR - Petticrew et al summarise studies over several decades
showing that what cancer patients say about their attitudes to their
disease is not significantly related to survival outcomes. There is a
danger that this will be interpreted to mean that there is nothing these
people can do to help themselves live longer by psychological means. Such
a conclusion would be unwarranted from evidence that is confined to
administering self-report questionnaires at a single point in time. As in
other fields, what people say, under such conditions where socially
desirable responses are evident, is not nearly as important as what they
actually do. One would not, for example, assess the health value of
exercise solely by asking people whether they thought it was a good idea.
It is the impression of many clinicians engaged in helping cancer
patients help themselves with psychological and spiritual techniques that
becoming strongly involved with such methods and philosophies can indeed
make a difference to longevity in some cases. We have recently published
some evidence from a rigorous, correlative study on this question. One of
the difficult features of this research is that randomised controlled
trials are of limited applicability, since relatively few patients are
aware of, or motivated to make, the kinds of substantial mental changes
that appear to be needed to strengthen the body's cancer-regulating
mechanisms. Case by case analyses are thus required, to identify these
unusually motivated people. While the issue is certainly not resolved as
yet, it is important that we retain an open mind on the question of
educating patients to help themselves as a potentially valuable additional
resource in fighting serious chronic disease.
Alastair J Cunningham, PhD, C.Psych,
Senior scientist
Ontario Cancer Institute,
610 University Avenue,
Toronto, ON, M5G 2M9, Canada.
No competing interest
Petticrew M, Bell R, Hunter D. Influence of psychological coping on
survival and recurrence in people with cancer: systematic review. BMJ
2002; (9 Nov)
(Please note - pg #s not available from electronic copy)
Cunningham A J, Edmonds C, Phillips C, Soots K, Hedley D, Lockwood G.
A prospective, longitudinal study of the relationship of psychological
work to duration of survival in patients with metastatic cancer. Psycho-
oncology, 2000; 9: 323-339
Competing interests:
None declared
Competing interests: No competing interests