Your Mood Does Not Affect Your Cancer Prognosis
Hester Hill Schnipper, LICSW, OSW-C Program Manager Emeritus, Oncology, Social Work
DECEMBER 15, 2022
Although I have written about this before, it keeps coming up. Almost weekly, I try to convince people that normal sadness and anxiety about cancer and cancer treatment do not affect prognosis. It does not matter at all if you are furious, depressed, frustrated, cheerful or hopeful. Mood has nothing to do with the outcome.
Remember that cancer is all about biology. This frequent fear of cancer patients — that negative thinking harms recovery or worsens prognosis — has been a Damocles’ sword hanging over far too many heads. It also, of course, is circular in nature; it is easy to think along the lines of: Being distressed will make my cancer worse, and the worse it gets, the more distressed I will be, and then it will be my own fault if the cancer comes back.
Well-meaning friends often exacerbate these worries by reminding us You have to think positively or Think about good things; I know you are going to be fine. Not only are these directives annoying, but also, after a time, even the most resilient among us may begin to wonder if they are actually true. In other words, when you hear something enough, it can take on a life of its own. It does not help if we begin to think these messages might be true.
A number of thoughtful and careful studies have proven that outlook and attitude make no difference in cancer outcomes. Again, let me remind you that cancer is all about biology and the response of the particular cancer cells to treatment. Those cells are not paying attention to their host’s mental state or anger management skills.
There never has been a well-designed study to reach a different conclusion. Although there is much written in the popular press about mood or personality type in relation to cancer, it is basically hogwash. My own instinct is that such commentaries are one way that people who have not had cancer try to convince themselves that they will never have the disease. They also may be aiming to encourage a sense of control. If you can believe that positive thinking and a sunny outlook guarantee your health, you can feel safer in the world. Of course, the reality is more likely that such beliefs only reinforce our worries and self-criticisms for not being completely happy and optimistic.
Having spent more than forty years working with cancer patients, I have never believed this line of thinking for a minute. Each week, I sit with people of every possible flavor and style. The only common denominator is being human.
Of course, your mood influences the quality of your life and the enjoyment of your days. If you spend your time sad and anxious, the quality of your life will suffer. Your cancer, however, will not be impacted at all. The surgery, chemotherapy, radiation or hormone therapy will work just as well whether you are crabby and pessimistic or annoyingly cheerful.
Next time you are having a bad day, don’t feel self-critical or worried. It would be very rare for a person with cancer not to have some hard days. Allow yourself, without guilt, to feel as sad, anxious, frustrated or angry as you need to feel — and then move on toward a better day.