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Optimism Doesn't Prolong Lung Cancer Patients' Survival

But the finding may not apply to other types of cancer

MONDAY, Feb. 9, 2004 (HealthDayNews) -- An optimistic attitude, often touted as an important psychological tool against cancer, doesn't prolong survival for lung cancer patients.

Worse yet, telling such patients to have a positive outlook may even add to their burden, claims a somber Australian study in the Feb. 9 online issue of Cancer.

The study author is quick to add, however, that her team looked only at lung cancer, which typically has a bleak prognosis. People with other types of cancers may get greater survival benefits from a positive outlook, says Penelope Schofield, a research fellow at the Peter MacCallum Cancer Centre in Melbourne.

What's more, the findings shouldn't prompt lung cancer patients to give up hope, American cancer experts say, because keeping faith often enhances a patient's quality of life.

For years, optimism has been promoted as a route to extended survival for cancer patients. But the scientific data on whether a positive outlook really helps is actually mixed, Schofield says.

In the study, Schofield and her team followed 179 patients with non-small cell lung cancer, which has a very poor prognosis. The five-year survival rate is estimated at less than 15 percent, but can vary. The team followed the patients for five years, from their pre-treatment phase to their time of death.

The patients answered questions about their attitude and optimism before treatment began and again about six weeks after completing treatment.

Within the five years, 96 percent of the patients died. And the patients' level of optimism had no effect on overall survival time, nor did it halt progression of the disease, the researchers say.

They could find no evidence that optimism is related to increased survival in lung cancer patients, they conclude.

Schofield adds that pushing optimism on certain cancer patients might be a bad idea.

"What I am concerned about is that some patients may feel a 'social pressure' to be positive to increase their chances of survival, with the unintentional implication that they are ultimately responsible for the outcome of their disease," she says.

Patients projecting a forced optimism, she says, may conceal their distress and limit honest conversation "at a time when it is so important to be able to be open about your feelings with your loved ones."

Although optimism did not impact survival rates with lung cancer, the same may not hold true for other cancers that typically involve better odds, she stresses.

"It is possible, particularly for cancers with a better prognosis, such as breast cancer or prostate cancer, that being optimistic may influence survival because optimism may influence the way people care for themselves," Schofield says. They may eat a healthier diet, for instance, exercise more or quit smoking.

Dr. LaMar McGinnis, past president and senior medical consultant for the American Cancer Society, says the new study adds "balance" to the ongoing debate about whether optimism plays a role in cancer patients' survival.

Despite much publicity about the value of optimism, he says, "there is not a lot of scientific data to prove that your attitude improves your response to therapy."

However, a positive attitude may have other pluses besides extending survival time, McGinnis and Schofield agree.

"It may improve your quality of life," McGinnis says.

And the study, he adds, shouldn't make people give up hope.

"Hope is very important. As long as you have hope, you are likely to do the other things that add to your quality of life," he says, such as adhering to a treatment regimen.

Because of medical advances, many cancers are now considered chronic diseases, McGinnis adds, so maintaining hope is becoming even more critical.

More information

Ever wonder what to say to someone diagnosed with cancer? The American Cancer Society offers some suggestions. The society also has lots of information about the disease.

SOURCES: LaMar McGinnis, M.D., past president and senior medical consultant, American Cancer Society, Atlanta; Penelope Schofield, Ph.D., research fellow, Peter MacCallum Cancer Centre, Melbourne, Australia; Feb. 9, 2004, online edition, Cancer
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