Research on Psychology and Cancer: Still in its Infancy?

How do thoughts, emotions and social environment influence people diagnosed with breast cancer?

A report by Falagas and his colleagues looked at and compared 46 studies investigating psychological and social factors that affect breast cancer survival rates. The results are not entirely conclusive. The most promising parameters associated with better breast cancer prognosis were social support, minimizing and to some degree being married.

Social Support

An example of the role of social support is a study by Reynolds and her team. The absence of close ties and perceived sources of emotional support were associated significantly with an increased breast cancer death rate. Women reporting few sources of emotional support had a higher death rate from their disease during the 5-year period of follow-up.

Marital Status

When taking a close look at Falagas’ study, I was not able to see the evidence of the benefit of marriage for breast cancer survival they claimed. Interestingly, a study in 1987 by Goodwin et al. has this to say about the connection between marital status and any kind of cancer:

The effects of marital status on the diagnosis, treatment, and survival of patients with cancer were examined in population-based data on 27,779 cancer cases. Unmarried persons with cancer had decreased overall survival … We identified three complementary explanations for the poorer survival of the unmarried persons. Unmarried persons were more likely to be diagnosed at a regional or distant stage [and were] more likely to be untreated for cancer… Previous studies have demonstrated that unmarried persons have decreased overall mortality. For cancer, our results suggest that the favorable consequence of being married on overall survival is secondary to the beneficial effects at several steps in the diagnosis, choice of treatment, and response to treatment.

Minimization

Minimization is a coping mechanism that involves strategies such as not thinking about a problem too deeply, trying to forget one’s feelings, or downplaying risks. In a study by Butow, Coates and Dunn, the risk of dying was reduced by 7% for each unit increase in minimization, and survival time was increased by a median of 5.2 months after study entry for those scoring higher than average on minimization.

Emotional Wellbeing

Lastly, you may remember that recently, there was quite a bit of talk about a study involving neck and head cancer. In the large-scale study conducted over nine years, Coyne and colleagues used baseline quality-of-life questionnaires to assess the well-being of 1,093 cancer patients. All participants were involved in clinical trials, which ensured uniformity of treatment and ruled out substantial health disparities in the sample. During the study, 646 patients died, and the research team found no relationship between their emotional well-being and cancer progression and death.

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It seems that this area of cancer research is still in its infancy; indeed, a recent gap analysis states that the psychosocial aspects of cancer — the use of appropriate psychosocial interventions, and the personal impact of all stages of the disease among patients from a range of ethnic and demographic backgrounds — still needs a lot more attention.