[Do psychological factors modify survival of cancer patients? I: Review of the literature].
The present paper addresses the question whether psychological factors influence the course of the disease in cancer patients. Studies investigating this issue are reviewed from a methodological point of view. The main objective is to design guidelines for future research. The review begins with Greer's and his co-workers' study on breast cancer patients. They demonstrated that ways of coping called fighting spirit and denial are predictive of longer survival. However, axillary lymph node status and oestrogen receptor status could not be controlled, because these measures had not been assessed on a routine basis at the time of diagnosis. The Greer study has been stimulating a series of replications. Moreover, investigations into patients with various other cancer sites including melanoma and lung cancer have been performed. In general, results were inconsistent. Studies with positive findings are contrasted by those with negative results. Within positive findings, results were partially contradictory. Moreover, most of the investigations suffered from serious methodological limitations rendering interpretation difficult. The following methodological conclusions can be drawn: Testing of a priori hypotheses instead of multiple retrospective tests; prospective design to prevent that psychological predictors turn out to be indicators of the somatic state of the patient; multi-method and longitudinal assessment of coping and adaptation; homogeneous sample; taking into account all known biological prognostic factors; multivariate statistical analysis.
Faller
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Institut für Psychotherapie und Medizinische Psychologie der Universität Würzburg.
D000223:Adaptation, Psychological; D001943:Breast Neoplasms / Q000401:mortality / Q000523:psychology; D003717:Denial, Psychological; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000401:mortality / Q000523:psychology*; D011379:Prognosis; D012803:Sick Role; D016019:Survival Analysis