Patients with positive view `live longer'

Cancer patients can live longer, have a better quality of life and can actually affect the way their bodies handle the disease if they have a positive attitude to the illness, according to a researcher from the University of Hull.

Prof Leslie Walker, director of the Institute of Rehabilitation at the university, was speaking on the second day of the National Cancer Institute All-Ireland Cancer Conference in Belfast. The conference closes later today.

Having a positive attitude can be "a significant advantage in terms of duration of survival", he said. New research had also shown that patients who undertook relaxation and disease "visualisation" - during which they imagine their immune systems attacking cancer cells - caused changes in their immune biochemistry. Prof Walker quoted from a number of studies which looked at the value of "psycho-social intervention" for cancer patients. This included counselling, discussion groups and support for patients as they attempted to cope with a cancer diagnosis.

The question, he said, was to establish the benefit, if any, from maintaining a "fighting spirit" when faced with the disease. "To what extent and in what way does the attitude to the illness make a difference to outcome?"

This could be examined at two levels. The person's quality of life, and the incidence and severity of the side-effects of chemotherapy and mood could be considered.

One study at Stanford in the US involved 86 women with breast cancer who were monitored over a 10-year period. Those who had received intensive group therapy interventions had double the average survival rate - 36 months post-diagnosis versus 18 months - of a control group which did not receive the therapy.

A University of California study of 68 malignant melanoma patients who received six one-hour psychological interventions lived "significantly longer" than controls, he said.

Prof Walker described a study of his own in which 96 female breast cancer patients from northeast Scotland were randomised for a trial which looked at both the psychological impact and the "psycho-biological effects" of this sort of intervention.

Both groups of women were given a high level of social support when they began coming in for initial chemotherapy before surgery and later radiation treatments. Half the group also received additional psychological support including "cue control", a relaxation method, and "guided imagery", the use of mental imagery in which the patient pictures their immune systems attacking cancer cells.

"When we are talking about relaxation response we are not just speaking about a relaxed state but an actual biological response," he said. "The main findings were that the women trained in relaxation and imagery had a significantly better mood and were more relaxed and confident with their condition." They coped better and became more socially expressive.

Blood samples were also taken to assess their "host defences", however, with measurements of a range of immune cell counts including T-cells and other immune response markers. These were found to be elevated in women who had the additional training.

"It is very exciting. I don't know where it is going," Prof Walker said. "My conclusion is that a great deal can be done to help patients cope with a diagnosis and treatment of cancer." Current theories suggest that the benefit of the extra programmes was in giving the patient new "coping strategies" that could help to reduce levels of stress.