Psychosocial correlates of cancer survival: a subsequent report 3 to 8 years after cancer diagnosis.

Abstract

Professional and public interest in possible relationships between psychosocial factors and disease outcome continues to increase. Published research in this area, however, is marked by contradictory results. Positive relationships between a variety of psychosocial factors and length of survival from cancer are reported, but other studies uncover no such associations. In a previously reported prospective investigation of 359 patients with newly diagnosed malignant diseases, we found no relationship between clinical outcome and any psychosocial factor studied. We have continued to observe these patients, who are now up to 8 years post-diagnosis, and report here additional data on their disease outcomes as they relate to psychosocial factors assessed at diagnosis. Two groups of patients were studied: 204 patients with advanced, prognostically poor malignant disease at diagnosis; and 155 patients with intermediate or high-risk melanoma or breast cancer. Shortly after diagnosis, patients completed a self-report questionnaire that assessed seven psychosocial factors previously reported to predict longevity in the general population. Factors included social ties and marital history, job satisfaction, use of psychotropic drugs, general life satisfaction, subjective view of adult health, hopelessness, and perception of amount of adjustment required to cope with the new diagnosis. Clinical factors--performance status and extent of disease at diagnosis--predicted clinical outcome. No psychosocial factor consistently was associated with length of survival or remission. Results of additional exploratory analyses also are reported.

Social Inequalities and Cancer

“…This could not be confirmed in another study (Cassileth et a/., 1988). Similarly, the initial findings on the effects of adverse life events on relapse of breast cancer (Ramirez et al, 1989) have not been supported by subsequent research (Barraclough et al, 1992).…”

Can the Spitzer Quality of Life Index help to reduce prognostic uncertainty in terminal care?

“…Instead, it has been suggested that clinical features such as performance status and the presence of certain symptoms may give a better idea of prognosis (Cassileth et al, 1988;Reuben et al, 1988). For instance, Reuben et al (1988) found that the predictive power of the Karnofsky Index was improved when combined with five symptoms (shortness of breath, problems eating or loss of appetite, trouble swallowing, dry mouth and weight loss) which had independent predictive value.…”

“…Evidence from previous studies suggest that knowledge of the patient's sex, age, primary tumour type or site of metastases may contribute little to the prediction of survival times (Reuben et al, 1988) and that the same is true for psychological factors such as feelings of hopelessness, life satisfaction and the amount of adjustment needed in response to initial diagnosis (Cassileth et al, 1988). Instead, it has been suggested that clinical features such as performance status and the presence of certain symptoms may give a better idea of prognosis (Cassileth et al, 1988;Reuben et al, 1988).…”

Gender disparity in the rate of partner abandonment in patients with serious medical illness

“…13,14 Although many community resources and family members can serve important caregiving roles, the presence of a dedicated spouse may be the most important component of strong social support. Not surprisingly, therefore, most studies have supported the hypothesis that all-cause mortality, cancer-specific mortality, and quality of life are better in married than unmarried cancer patients across many different tumor types, [15][16][17][18][19][20][21][22][23] including primary brain tumors. [24][25][26] This information is important for counseling patients, marshalling resources, and designing clinical trials.…”