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Dr West

FAQ: How Much Does Attitude Matter When Fighting Cancer?

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Most people feel a loss of control when faced with a new diagnosis of cancer. You can meet with doctors, develop a plan, perhaps do surgery, radiation, chemotherapy, targeted molecular therapy,  immunotherapy, or some combination of these.  But beyond showing up and taking recommended interventions, how much does a positive attitude help?

While it’s comforting to think that you can control much of your outcome and some argue that a positive attitude makes all of the difference, cancer experts are largely humbled by how little control we have over the outcome, even with the many potentially effective tools we have at our disposal. Patients need a positive attitude in order to pursue the treatments that can be very effective rather than just giving up, but the truth is that a positive attitude can’t overcome a very aggressive cancer biology.

It would be nice to live in a world where a positive attitude makes all of the difference in overcoming a nasty cancer, but to be honest, that’s a make-believe world of rainbows and unicorns. 

 Rainbows and unicorns

Why are cure rates so high for some cancers — like testicular cancer, breast cancer, and prostate cancer, for instance — but low for others — such as pancreatic cancer, mesothelioma, and lung cancer? It’s not that the vast majority of breast cancer patients have a good attitude and over 90% of patients with pancreatic cancer have a poor attitude, but rather that cancers have totally different biologies that make them more or less amenable to being cured.  Oncologists know that we can treat 10 people with the same chemotherapy combination for the same disease and see some respond beautifully, others have a minor response or period of stable disease, and others will progress right through the same treatment.  There are differences in the biology of cancers that make that happen, and we only understsand bits and pieces of that.

One unfortunate extension of the idea that having a positive attitude is critical in fighting cancer is the implication that people whose cancers progress and lead them to do poorly just aren’t fighting hard enough.  We all want to have control in an all-too-uncontrollable situation, but the reality is that attitude, diet, exercise, and even the recommended treatments are modifiers that are ultimately secondary to the most powerful driver of cancer outcome, which is the underlying biology of that cancer.


5 Responses to FAQ: How Much Does Attitude Matter When Fighting Cancer?

  • cards7up says:

    I totally understand that attitude will not affect the outcome of how your treatment works, but it is one the things you do have control over, your mind. I’ve always tried to be positive and that’s not to say it helps my cancer, but it helps my cancer journey. I think this is where people misunderstand when we say be positive. As they say, if all it took was love to cure cancer, then many would be cured!
    Take care, Judy

  • Dr West
    Dr West says:

    I completely understand and don’t want to minimize any patient efforts. At the same time, I think it’s potentially harmful to suggest, explicitly or not, that someone whose cancer is progressing just has the wrong attitude.

    Perhaps we can agree that it’s great to have patients take some credit if doing well but not assume blame if their cancer is getting worse.

    -Dr. West

  • cards7up says:

    My point was missed here I think. It’s not about controlling our cancer, we have no control over that. How we handle life with cancer is the attitude I’m thinking about. Even when it comes to making decisions about continuing treatment or not, our attitude can make the difference. As with cancer, we’re all different in how we think and feel about our cancer and just being there for someone is what counts! Take care, Judy

  • Dr West
    Dr West says:

    Thanks, and I do agree with that.

    -Jack

  • wadvocator says:

    I do agree that if one interprets “fighting cancer” strictly to the biological system of the body, then attitude doesn’t make much difference. If one expands that interpretation broader, then attitude does matter. It is the attitude that leads to doing things within one’s control that hopefully will improve one’s performance status to improve the quality of life, to build reserve for the next treatment, and to allow additional scientific progress be made. It is also that same attitude that enable caregivers. It is about human HOPE and THANKFUL for the progress being made on the biological front.

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