Positive thinking 'has no impact on cancer survival'

The widespread belief that thinking positively prolongs survival from cancer is a myth, researchers say today.

A positive outlook combined with a fighting spirit is often said to be the best way of dealing with cancer. Patients are commonly portrayed as engaged in a "battle" which they confront "bravely".

But the reality is that however they face the disease, whether with optimism or fatalism, hope or despair, anger or acceptance, the outcome is the same.

Mark Petticrew and colleagues from the Medical Research Council's Social and Public Health Sciences Unit at the University of Newcastle identified seven psychological coping styles and found none was better than any other in terms of prolonging survival or preventing recurrence.

The finding should relieve cancer patients of the tendency to blame themselves. Dr Petticrew said: "The message is that people living with cancer should not feel obliged to respond in any particular way. That is the really important thing. There have been suggestions that cancer patients have felt under moral pressure to react in a certain way."

The researchers reviewed 26 studies of the influence of psychological coping styles. The findings are published in the British Medical Journal.

The studies showed that people respond to a diagnosis of cancer in many different ways. After the initial shock, some react in a combative manner, adopting a fighting spirit. They will characteristically scour the internet for information, experiment with alternative treatments, and examine their lives for clues to the cause of the disease or ways to attack it.

Others react with helplessness or hopelessness, become anxious and depressed, and fear what the future holds. A third group react with denial, avoiding discussion of the subject and continuing with their lives as if nothing had happened. This also characterises those who acknowledge the seriousness of the diagnosis but carry on, stoically accepting their fate.

Dr Petticrew, a psychologist and associate director of the MRC unit, said the idea that mental attitude was important in cancer had developed because it had biological plausibility. "It has often been suggested that stress involves the production of cortisol and other hormones which have a suppressant effect on the immune system. So it might have an effect on cancer survival."

Although the review showed there was no effect on length of survival or recurrence, the researchers did not study quality of life, an area where mental attitude is likely to have more impact. Dr Petticrew said: "Our findings do not mean that having a positive mental attitude isn't a good thing generally. People with a positive mental outlook are more likely to comply with their treatment, suffer less anxiety and depression, and have a better quality of life – they just won't live longer."