title: Optimism and survival in lung carcinoma patients.
abstract: BACKGROUND
  It is popular belief that the psychologic response to a diagnosis of cancer influences survival in patients with cancer; however, research has produced contradictory results. In this prospective study, the authors investigated the relation between pretreatment levels of optimism and survival in patients with nonsmall cell lung carcinoma (NSCLC).
  
  
  METHODS
  Two hundred four patients who were participating in a randomized trial that compared accelerated and conventional radiotherapy with and without carboplatin chemotherapy were asked to complete two questionnaires assessing optimism. The first assessment was just prior to commencing treatment and the second assessment took place after completing treatment. Survival was measured from the date of randomization to the date of death. Surviving patients were followed until February 8, 2001.
  
  
  RESULTS
  The pretreatment questionnaire was completed by 179 patients, and 148 of those patients completed the posttreatment questionnaire. There was a small but significant reduction in optimism scores after treatment (P = 0.005). There was no association noted between pretreatment optimism and progression-free survival (P = 0.52, unadjusted; P = 0.22, adjusted for Eastern Cooperative Oncology Group performance status and patient age), nor was there an association noted between pretreatment optimism and overall survival (P = 0.36, unadjusted; P = 0.19, adjusted for disease stage).
  
  
  CONCLUSIONS
  There was no evidence that a high level of optimism prior to treatment enhanced survival in patients with NSCLC. Encouraging patients to "be positive" only may add to the burden of having cancer while providing little benefit, at least in patients with NSCLC.
authors.affiliation: Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia. penelope.schofield@petermac.org
authors.forename: Penelope
authors.initials: P
authors.lastname: Schofield
authors.forename: David
authors.initials: D
authors.lastname: Ball
authors.forename: Jennifer G
authors.initials: JG
authors.lastname: Smith
authors.forename: Ron
authors.initials: R
authors.lastname: Borland
authors.forename: Peter
authors.initials: P
authors.lastname: O'Brien
authors.forename: Sidney
authors.initials: S
authors.lastname: Davis
authors.forename: Ian
authors.initials: I
authors.lastname: Olver
authors.forename: Gail
authors.initials: G
authors.lastname: Ryan
authors.forename: David
authors.initials: D
authors.lastname: Joseph
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality* / Q000523:psychology*; D004644:Emotions; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality* / Q000523:psychology*; D008297:Male; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016019:Survival Analysis