Brad Evenson National Post

Friday, November 08, 2002

Cancer patients who have a positive attitude don't survive any longer than patients who feel angry, helpless or depressed, a new study of 5,000 patients says.

"There's nothing wrong with being bloody miserable, and surely, cancer patients sometimes have a right to be," said study co-author Mark Petticrew, a professor of public health sciences at the University of Glasgow, Scotland.

"Cancer patients sometimes feel a sort of moral pressure to adopt a positive mental attitude on the grounds that if they don't, it's going to affect their survival rates. Some patients have talked about that constituting a form of oppression."

The researchers stress that cancer patients with a positive attitude have a better quality of life. They just don't live any longer.

Research has shown, for example, that hormones produced by negative feelings of stress can suppress the immune system. But whether this influences survival in cancer has never been clear.

In a study published today in the British Medical Journal, Dr. Petticrew and his colleagues examined 26 studies -- looking at about 5,000 patients -- from Canada, Australia, Sweden, the United Kingdom, the United States and the Netherlands to see whether a "fighting spirit" helped patients live longer.

Many of the studies measured such qualities as hopelessness, fatalism, denial and positive attitude.

Overall, Dr. Petticrew said, no psychological coping style had an influence on survival.

"We're not saying don't have a positive mental attitude," he said.

"It's just that there's no good, consistent evidence that it will impact significantly on survival from cancer or recurrences of cancer."

The researchers acknowledge their findings are not what society wants to hear.

"Somehow we think a more positive outlook is going to help us deal with, really, any kind of problem," said co-author Duncan Hunter, an assistant professor of community health and epidemiology at Queen's University in Kingston, Ont.

"We're worried that some people are being asked to change their fundamental psyches. And as you know, some people are optimists and some are pessimists, and those lead to different coping styles."

Dr. Hunter said medical journals have published studies that show a survival benefit from a positive attitude, but these were small studies.

Researchers tend to submit only positive findings for publication, while negative studies go unpublished. This is known as publication bias.

"What if those pessimistic coping styles are actually more beneficial?" Dr. Hunter mused.

The news comes as no surprise to Ed Watson. Diagnosed with stomach cancer in 1995, the retired Winnipeg road construction worker had no urge to "spray sunshine out my ass," as he caustically puts it. Instead, he pulled shut the blinds on his apartment and growled at wellwishers who called. Yet, unlike 70% of patients diagnosed with his type of cancer, he survived.

"My doctor told me to be positive," Mr. Watson said.

"I told him to go to hell. If the cancer was going to kill me, smiling wasn't going to make any difference."

However, some experts say there is a need for more detailed research.

"My view is that healing is something that can be learned and it can come a great deal from within," said psychiatrist Alastair Cunningham, a senior scientist at the Ontario Cancer Institute. "Whereas we tend always to look for it from outside. That's our culture."

A cancer survivor himself, Dr. Cunningham said he has conducted detailed studies in small patient groups that show a clear benefit in spiritual healing.

"We showed a huge effect," he said.

"Those who got very involved lived much, much longer, and a couple of them had complete remissions. These are people who had incurable cancers."

bevenson@nationalpost.com

-- Anonymous, November 08, 2002