Can a Positive Attitude Really Affect Breast Cancer Survival?

It's a lot of pressure to be positive all the time

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Social media outlets are full of comments from well-meaning individuals who remind those with breast cancer—any cancer for that matter—to fight their disease and keep a positive attitude. That's because these two activities are important to their survival.

Most of us have shared the same message with friends and loved ones living with breast cancer. But, while these messages are meant to be helpful, according to studies, they are neither constructive nor accurate. They place a burden on the person with cancer, who has enough on his/her plate trying to cope with fear, side-effects, financial worries, and the impact of cancer on their family. 

A diagnosis of cancer brings with it a range of emotions that make attaining and keeping a positive attitude an unrealistic challenge. Being told to keep a positive attitude often causes feelings of guilt for the person with cancer. Often times, those with cancer don’t share how they really feel for fear of not coming across positive, which only further isolates them at a time when they need all the support they can get.

Some patients themselves, as well as others in their circle of family and friends, want to believe that they have the power to control the outcomes of their serious illnesses. While this may bring comfort, it simply isn’t true. The problem with embracing such a belief system occurs when people with cancer aren’t doing well and start to blame themselves for their deteriorating health.

Then there are those that believe some people, based on their personalities, are probably more likely to get cancer and die from it. In reality, most study results show no link between personality and cancer. And, the few studies supporting this premise were found to be flawed because they were poorly designed and controlled.

For example, a 2007 study included more than 1,000 people with cancer. It found that a patient’s emotional state had no influence on his/her survival. Scientist and study team leader James C. Coyne, PhD at the University of Pennsylvania School of Medicine, reported that the results of the study added to the growing evidence that shows no scientific basis for the popular notion that an upbeat attitude is critical for "beating" cancer.

The largest and best-designed scientific study to date was published in 2010. The study followed 60,000 people for at least 30 years and controlled for smoking, alcohol use, and other known cancer risk factors. Not only did the outcome show no link between personality and overall cancer risk, but also that there was no link between personality traits and cancer survival.

There has been research in the areas of psychotherapy and stress reduction, with researchers looking at the possible effects on cancer survival. These studies resulted in mixed findings, leading to confusion for patients, family members, friends, and media.

A good example of this kind of confusion can be seen in a study done by David Spiegel and his colleagues in 1989, which seemed to link a difference in survival with being part of a support group. However, when other researchers performed similar studies, they did not get the same results.

Also, a 2004 study review—one that looked at the results of many well-designed studies of cancer patients getting psychotherapy—found that more than 1,000 patients, who were tallied in the final results, clearly indicated that being in therapy was helpful for coping with their cancer. However, it had no impact on survival.

In 2007, new researchers revisited all the previous studies about therapy and its impact on cancer survival. They found that no randomized clinical trial crafted to look at survival and psychotherapy has shown a positive effect on patient survival.

However, research does indicate that giving cancer patients access to information about their cancers in a support group environment, as well as giving them the opportunity to get and give support to others in the group, reduces tension, anxiety, fatigue, and may help patients cope with depression.

While support groups play a vital role in improving a patient’s quality of life, hard scientific evidence does not endorse the idea that support groups or other forms of mental health therapy can help people with cancer live longer.

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  • Coyne JC, Tennen H. Positive psychology in cancer care: bad science, exaggerated claims, and unproven medicine. Ann Behav Med. 2010;39(1):16-26. DOI: 10.1007/s12160-009-9154-z