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Today’s Host:Dana Nolan, MS LMHC

Licensed Mental Health Counselor

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Personality, Attitude and Cancer

Dana Nolan, MS LMHCLicensed Mental Health Counselor

Why Did Researchers Study Personality and Attitude in Cancer

Patients? In the 1970s, doctors diagnosed most cancers in the

advanced stages. Treatment options were limited. Prognoses were poor.

Psychologists wanted to study if psychosocial factors (personality, anxiety, depression, stress and attitude) could predict cancer and if psychosocial interventions could increase cancer survival.

Studies linking personality, attitude and cancer have not solely focused on mesothelioma, but they have included all cancer diagnoses.

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Does a Type C or Cancer-Prone Personality Exist?

In the 1970s, medical psychologists hypothesized Type C traits (tendency to suppress negative emotions, passivity and high anxiety) increased the risk of developing cancer.

They followed 1950s research, established by cardiologists Meyer Friedman and Ray Rosenman, that suggested Type A (high stress, competitive, aggressive) personalities were at higher risk of heart disease than those with Type B traits (more calm, less competitive or aggressive).

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Personality and Cancer Research

For the last several decades, academic and clinical researchers have been investigating the relationship between personality traits and risk of getting cancer and cancer survival.

The majority of the studies showed no link between personality and cancer.

The few studies that did suggest a link enrolled few people and lacked sufficient case control.

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Research Results

The latest, most significant study in 2010 followed 60,000 people over 30 years. Researchers measured personality traits, cancer risk factors (smoking, exercise, exposure to known carcinogens) and whether they developed and survived cancer.

The study showed no link between personality and cancer risk or survival.

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More Research Results

Japanese study investigated four personality factors in about 30,000 people over eight years. Conclusion: “Our data do not support the hypothesis that personality is a risk factor for cancer incidence.”

Swedish and Danish researchers studied 29,000 twins over a 30-year period to investigate the relationship between personality traits and risk of cancer. No correlation found.

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Attitude and Cancer

Many cancer patients believe or have been told they need to have a positive attitude, avoid becoming overwhelmed with stress or both to survive their cancer.

Beginning in the 1980s, there were plenty of studies on the relationship between having an optimistic or positive attitude and length of cancer survival.

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Why Research Attitudes of Cancer Patients?

Anecdotal stories circulating within cancer support groups and cancer clinics indicated people with a positive attitude lived longer and those with a pessimistic attitude.

As a result, some patients reported feeling pressure to maintain a positive attitude at all costs, or they would not survive their disease.

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Why Research Attitudes of Cancer Patients? (cont.)

Psychologists used that information to help pessimistic and overstressed patients through psychological interventions.

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Importance of Longitudinal Research

Studying cancer patients’ attitudes and stress levels over a period of years (sometimes decades) let researchers determine if patients simply felt more hopeful and less stressed when their illness responded favorably to treatment.

It is understandable that patients would feel less hopeful and stressed when their cancer was not responding to treatment or getting worse.

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Research Results Again, a few small studies showed cancer patients

with a positive attitude or those who attended a support group lived longer than those who didn’t follow that pattern.

However, the majority of well-designed, larger studies that followed patients for an extended period of time indicated a patient’s optimistic attitude throughout their cancer journey did not extend their life, but it did improve their quality of life.

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Patient-Focused Resources on Research

Great websites that highlight the research and explain research results in layman’s terms:National Cancer InstituteAmerican Psychological AssociationAmerican Cancer Society

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Quality of Life Improvements While the consensus in the field of psycho-oncology

research is that having a positive attitude does not extend one’s life, there are still many demonstrated benefits of trying to remain realistically optimistic and manage stress in a healthy way.

Quality-of-life research has demonstrated that trying to remain hopeful and engaging in healthy coping strategies improved a cancer patient’s quality of life.

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What Is Quality of Life?

Health-related quality of life (HRQOL) refers to one’s overall well-being and the ability to do the things they want to do. Factors that affect HRQOL: Pain level Fatigue levelAbility to engage in activities such as socializing, working

or hobbiesAbility to enjoy food and drinks

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Making Sense of Attitude and Mesothelioma

It is not possible to be positive all the time when you have mesothelioma. Pressure to adopt an aggressive, positive spirit actually leads to more distress in cancer patients.

Psycho-oncology experts emphasize the importance of acknowledging all the emotions that accompany a cancer experience such as hopefulness, fears, stress, losses and joy of positive news. Many cancer patients have felt guilty they haven’t been positive enough if their cancer treatment doesn’t work.

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Finding Your Own ‘Cancer Attitude’

“We want to recognize that there are lots of individual differences in coping with cancer. People have to do what is comfortable with

them, but they have to do without the burden of thinking they’ve got to have the

right attitude to survive.” - James Coyne, Ph.D., well-known psycologist and former

director of behavioral oncology at the University of Pennsylvania Health System

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Sources and References to Journal Articles on Attitude and Cancer

Bennett, K.K., Compas, B.E., Beckjord, E. et al. (2005) Self-blame and distress among women with newly diagnosed breast cancer. Journal of Behavioral Medicine, 28, 313-323.

Chow, E. Tsao, M.N., Harth, T., (2004) Does psychosocial intervention improve survival in cancer? A meta analysis. Palliative Medicine, 18, 25-31.

Coyne, J.C., Pajak T.F., Harris, J. et al. (2007) Emotional well-being does not predict survival in head and neck cancer patients: A radiation therapy oncology study group. Cancer, 10, 2568-2575.

Hansen, P.E. et al. (2005) Personality traits, health behavior and risk for cancer. Published online January 13, 2005 on www.intersciencewiley.com

Keeling, M., BambroughJ., Simpson, J., (2013) Depression, anxiety and positive affect in people diagnosed with low-grade tumors: the roll of illness perceptions. Psycho-oncology, 22(6), 1421-1427.

Nakaya, N. et al. (2010) Personality traits and cancer risk and survival based on Finnish and Swedish registry data. American Journal of Epidemiology, 172(4), 377-85.

Nakaya, N. et al. (2002) Personality and the risk of cancer. Journal of the National Cancer Institute, 95(11), 799-805.

Spiegel, D., Bloom, J.R., Kraemer, H.C. et al. (1989) Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet, 2, 888-891.

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