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Archive for Sunday, October 20, 2002

Positive attitude no cure for cancer, study finds

Research concludes life isn’t prolonged by upbeat frame of mind

October 20, 2002

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— New research has dealt a blow to the idea that a positive outlook might improve a patient's chances of surviving cancer, scientists said Saturday.

However, experts said it is still worthwhile for patients to improve their attitude, perhaps by joining a cancer support group, because it does make them feel better.

The findings were presented Saturday at a meeting of the European Society of Medical Oncology in Nice, France.

The study evaluated whether psychologist-run support groups kept patients alive. The researchers conducted a systematic review of the evidence on the topic.

"There were some studies out there showing that positive thinking type of support will not only improve your quality of life which undoubtedly it does, I'm not questioning that but also will prolong the lives of cancer patients," said Dr. Edzard Ernst, a professor of complementary medicine at the University of Exeter in England who led the study.

"One study from 1989 gets cited over and over and over again, and we knew there were one or two negative studies on this too, so we decided to see if it was true," he said.

No ready handle

The researchers analyzed 11 studies that included a total of 1,500 patients.

"The data provided no evidence at all to show that these types of approaches prolong life in cancer patients," Ernst said.

He said, however, that he favored such efforts because they helped cancer patients cope with their disease.

"Clearly the Holy Grail is to help people live longer, but the flip side is you can't make data out of nothing," said Dr. Nathan Cherney, a palliative care specialist at the Shaare Zedek Medical Center in Jerusalem, who was not connected with the research.

"We like to believe we have a ready handle on cancer; we like to believe we have control, but the truth of the matter is the studies seem to indicate that we don't," Cherney said.

Realistic expectations

Perhaps the disappointing findings might help some patients to have more realistic expectations, he said.

When patients relapse, they sometimes feel guilty, Cherney explained.

"The people who have been drawn in by this power of positive thinking thing We've had situations of husbands berating their wives that they haven't been doing enough meditation, that they haven't been thinking positively enough," Cherney said. "This whole school of thought created an illusion of control, and when people do poorly, it's as if to say they haven't managed to control their tumor well enough, and that's not fair."

However, Cherney said the ability of psychological support to improve the lives of cancer patients should not be underestimated.

Experts say doctors are increasingly recognizing the value of palliative care, treatments that do not prolong life or fight cancer, but make life better for patients with incurable diseases.

"Some of them need palliation for their symptoms from the earliest stages of their disease, regardless of surgery, chemotherapy, radiation therapy," said Dr. Paris Kosmidis, head of medical oncology at Hygeia Hospital in Athens, Greece, the incoming president of the European Society of Medical Oncology.

As part of that recognition, the organization has established a committee to spread the latest knowledge on palliation throughout Europe. The organization has also started a palliation fellowship program and drafted guidelines for supportive cancer care.

"The big issues are management of physical symptoms and management of psychological symptoms such as depression, anxiety, suicidal thoughts," said Cherney, who sits on the European society's committee.

Cherney presented results Saturday of a survey of attitudes to supportive cancer care among European and American oncologists.

He found that, overwhelmingly, oncologists have the right attitudes but think it's a job for someone else.

"We found that about 20 percent of oncologists have pervasively negative views about treating people with advanced cancer, particularly dying patients. They don't want to be involved in it. It depresses them. It burns them out," he said.

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