Lung cancer research explores the effects of patient attitudes on patient outcomes

March 3, 2010

Research published in the March edition of the Journal of Thoracic Oncology (JTO) explored the importance of a patient's outlook as it relates to health behavior and health status. Researchers focused on lung cancer patients and discovered that those who exhibited an optimistic disposition experienced more favorable outcomes than those with a pessimistic disposition.

Previous research into how the body communicates with the mind has demonstrated a connection between pessimistic outlook and negative health behaviors. The examination of a possible relationship between patient outlooks and survivorship in oncology populations is a relatively new and provocative area of investigation, and such studies have yielded mixed results. Some suggest that having a pessimistic personality before receiving a cancer diagnosis might be predictive of survival time and immune function; whereas, others have not found such an association. This newly released study builds on the existing research to gain knowledge specifically toward the effect of attitudes on patients.

Utilizing the Optimism-Pessimism scale (PSM) of the Minnesota Multiphasic Personality Inventory (MMPI), the study investigators identified pessimistic and non-pessimistic or optimistic personality styles among patients. Researchers performed a retrospective evaluation of 534 adults diagnosed with lung cancer who had completed a MMPI about 18 years before receiving their lung cancer diagnosis between 1997 and 2006. Patients (both women and men) classified as having an optimistic attitude survived an average of six months longer compared with the patients with a pessimistic attitude. Five-year survival rates for the two groups were 32.9 percent for non-pessimists and 21.1 percent for pessimists. Furthermore, the relationship was independent of smoking status, cancer stage, treatment, comorbidities, age and gender.

Median survival:Five-year survival:
Overall14.8 months27.8%
Non-pessimistic19.2 months 2.9%
Pessimistic 13.1 months21.1%

"This six-month potential benefit related to an optimistic attitude is more impressive when one considers that the median survival time for this patient population with lung cancer is less than one year," explains the study's lead investigator Paul Novotny, MS of the Mayo Clinic. "Despite limitations, the results may provide insights for advancing patient care in cognitive therapy, one of the many treatment dimensions. This may ultimately aid in enhancing current approaches to patient care, such that clinicians may improve survival not only by developing new medical treatments but also by targeting patient's psychosocial characteristics most likely to negatively affect cancer treatment decisions and ultimate outcomes."

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