| Does the emotional state of a cancer patient | | | | reporting may be doing a great disservice to |
| have an impact on the progress of a cancer? This | | | | cancer patients and their families. One could easily |
| very sensitive question understandably never fails | | | | assume from reading these reports that the case |
| to generate controversy. | | | | of the impact of attitude and cancer was now |
| Recent media reports might lead many to | | | | closed. |
| conclude that the question has now been | | | | What many of the reports failed to include was |
| answered with a study claiming that there is no | | | | that this study is already drawing criticism from |
| connection between attitude and cancer. | | | | other experts. In digging a little deeper, examples |
| However, looking deeper into the study these | | | | of published reports of this criticism can be found. |
| reports are based on shows that the jury is likely | | | | For example, Dr. David Spiegel (associate |
| still very much out on the question. | | | | chairman of psychiatry and behavioral sciences at |
| Recently, a study from the University of | | | | Stanford University School of Medicine in |
| Pennsylvania (still yet to be published) was | | | | California) is reported (U.S. Health News, 22/10 |
| reported as concluding that the emotional attitude | | | | 07) as observing, "The authors (Coyne et al) |
| of a patient had no impact on survivor rate. This | | | | vastly overstate the quality of their data and the |
| conclusion was widely and prominently carried in | | | | findings. They used a subscale of a quality-of-life |
| the North American media. The front page lead | | | | measure which is hardly a reliable measure of |
| headline in my Montreal newspaper was typical | | | | depression and provides, by definition, limited |
| "Attitude Can't Beat Cancer" (Montreal Gazette, | | | | variance in mood, making it, by design, difficult to |
| October 22, 2007). | | | | show a relationship with any other variable." |
| The apparent strength of the study was in the | | | | Dr. Spiegel noted further "But positivity or |
| number of the patients. The study, expected to | | | | negativity are not the issue. What matters is the |
| be published in the Dec. 1 issue of Cancer, | | | | way in which a cancer patient approaches the |
| apparently drew data from almost 1,100 patients | | | | stresses in his or her life." |
| enrolled in two phase III clinical trials for new head | | | | Just these two aspects indicate to me that the |
| and neck cancer treatments. The patients | | | | study's conclusion is far from the definitive last |
| completed questionnaires about their attitude and | | | | word on the subject that it is portrayed to be. If |
| social networks at the beginning of the study and | | | | an expert of the caliber of Dr, Spiegel challenges |
| at follow-up. The questionnaire included five | | | | both the methodology and the relevance of the |
| questions to assess emotional well-being, including | | | | questions that the study asks, the least I can |
| such items as "I am sad" and "I am losing hope in | | | | conclude is that the jury is still very much out on |
| my fight against my illness." By the end of the | | | | this important question. |
| five-year study, 646 patients died. When the data | | | | The truly sad thing about all this is that people's |
| was analyzed, the researchers found that | | | | attitudes may be unnecessarily negatively |
| emotional status had no effect on the course of | | | | influenced by reading such reports with who |
| the cancer or the patient's survival. | | | | knows what damaging implications for their health. |
| In the rush for attention grabbing headlines and to | | | | We need to demand higher standards from our |
| get out a story, relevant and important criticism | | | | press when they are dealing with such important |
| of the study was missed by many of those in | | | | questions. This is no area for simplistic thinking. |
| the media. The conclusion as reported sounds | | | | What it does emphasize again to me is the need |
| plausible and authoritative. However, such | | | | for much more thorough research in this area. |