Cancer and Happiness

A new study in the December issue of Cancer reports that a self-report measure of well-being does not affect overall survival of patients with head and neck cancer. Quotes from the study authors are quite strongly worded. For example:

“The belief that a patient’s psychological state can impact the course and outcome of their cancer is one that has been prominent among patients and medical professionals, alike,” says James C. Coyne, PhD, Co-Leader, Cancer Control and Outcomes Program, Abramson Cancer Center; Professor of Psychology in Psychiatry at Penn; and lead author of the study. ...“While this study may not end the debate, it does provide the strongest evidence to-date that psychological factors are not independently prognostic in cancer management,” says Dr. Coyne.

However, there are some questions about the methodology employed in this study. First, the study looked at a self-report measure of emotional well-being at baseline. I wonder how the diagnosis of cancer might affect well-being across time. One could easily imagine someone indicating a high emotional well-being initially becoming devastated as cancer treatment progressed, while someone with low initial well-being may show resiliency and have higher emotional well-being during cancer treatment. This study tells me very little about the impact of emotional well-being in that it only looks at initial levels of well-being. A stronger design would have looked at how well-being changed throughout the course of cancer.