Attitude has no effect on survival in women with breast cancer

Many patients with cancer feel that their attitude towards the 'fight' is an important part of beating the disease, but maintaining a positive perspective is pretty tough in the face of a life-threatening malignancy.

A large, population-based study published in the Journal of Clinical Oncology has now found that psychosocial factors such as fighting spirit and fatalism have no effect on survival in patients with breast cancer. The authors Phillips et al. emphasize that their results could allay the concerns of anxious women who believe that their mental attitude towards breast cancer will affect their likelihood of survival, and could in fact lift the burden of responsibility such women may feel.

Phillips et al. studied 708 Australian women diagnosed with nonmetastatic breast cancer before the age of 60 (average age 40 years old). At study entry approximately 11 months after diagnosis, all women completed an array of psychosocial tests that were designed to assess factors such as anxiety and depression, coping style, and social support. These women were then followed up for an average of 8.2 years.

In total, 33% of women experienced distant recurrence of their cancer and 24% died during follow-up. Once the patient data had been adjusted to take into account other factors that affect chances of recovery, such as tumour size, no associations could be found between psychosocial factors and either distant disease-free survival or overall survival.

The authors conclude that their study does not support the controversial theory that psychosocial factors influence survival after breast cancer. They state, "This should be reassuring for women, particularly those who experience substantial levels of psychosocial distress after their diagnosis."

It is important to note, however, that therapies that aim to reduce psychosocial stress in women with breast cancer should not be discounted, as such interventions do seem to improve quality of life.

------------------------------------------------------------------------------------------------------------------
K.-A. Phillips, R. H. Osborne, G. G. Giles, G. S. Dite, C. Apicella, J. L. Hopper, R. L. Milne (2008). Psychosocial Factors and Survival of Young Women With Breast Cancer: A Population-Based Prospective Cohort Study. Journal of Clinical Oncology 26 (28): 4666-4671 DOI: 10.1200/JCO.2007.14.8718