【美癌协】性格与癌症(6万人、跟踪至少30年的一项优质研究)

来源: 闽姑 2013-09-16 20:13:47 [] [博客] [旧帖] [给我悄悄话] 本文已被阅读: 次 (15235 bytes)
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推荐有兴趣者读一读ACS的这一篇: Attitudes and Cancer 。不仅乐观本身与癌症预后没有关联,而且多年迷信的不良性格(如好强、焦虑、抑郁、不开朗、内向沉默等),即:癌症性格会导致癌症也无确切根据。积极的心态(positive attitude )并不能治疗癌症,它只能提高癌症患者的生活质量(第一段)。2010年发表的迄今最大规模最优质的研究(近60000人、跟踪至少30年)也表明癌症与性格无关(第二段末尾)。还有第三、第四段......读了这篇文章后,你有何感想? 对流传甚久的“心态胜过良药”和“癌症病人多数是被吓死的”这两句话有无新的感触和理解? 抑郁性格的人应该放松,不要有“癌症性格会导致癌症”的压力和精神负担,以为比别人更容易得癌。恐癌心理相当影响自己的生活品质。

确诊后癌症患者应该积极配合医生,用现代医学手段尽早治疗、乐观地生活; 或根据自己的病情和个人意愿选择姑息/舒适治疗,有尊严、无痛苦地离去。无论做什么样的选择,乐观、坚强地对待疾病和生活中的变化,都是值得钦佩和学习的。

Attitudes and Cancer

Emotions and feelings are an important part of coping with a cancer diagnosis. When a person is told they have cancer, questions like these may come up:

  • Did I bring the cancer on myself?
  • Can emotions really cause cancer to grow?
  • Can I control the tumor growth by visualizing how my body is fighting the cancer or by thinking myself well?
  • Would relaxation or keeping a “positive attitude” help cure my cancer?

Treatment that deals with our emotions and relationships (sometimes called psychosocial interventions) can help people with cancer feel more upbeat and have a better quality of life. But there isn’t good evidence to support the idea that these interventions can reduce the risk of cancer, keep cancer from coming back (prolong remission), or help the person with cancer live longer. Still, things like imagery, hypnosis, or relaxation can be used to help reduce the distress that often comes with a cancer diagnosis.

Personality traits and cancer

For many years there have been those who were convinced that people with certain personality types were more likely to get cancer. The common thought was that neurotic people and introverts were at the highest risk of cancer. Along with that, some believed that personality affected the outcome of cancer — the likelihood that a person with cancer might die.

Most of the study results on the subject tended to show no link between personality and cancer, but a few seemed to support the idea. Experts noted that many of these published studies were smaller, poorly designed, or not very well controlled. This means that their results were more likely to be due to bias or random chance. Also, some journals tended to publish the studies that suggested there was a link and reject those that showed no link. People are then more likely to read or hear about the few studies that seemed to show a link but not find out about those that didn’t show any link.

In 2010, the largest and best-designed scientific study to date was published. It looked at nearly 60,000 people, who were followed over time for a minimum of 30 years. This careful study controlled for smoking, alcohol use, and other known cancer risk factors. The study showed no link between personality and overall cancer risk. There was also no link between personality traits and cancer survival.

Does it help to keep a positive attitude?

People with cancer and their families may feel guilty about their emotional responses to the illness. They may feel pressure to keep a positive attitude at all times, which is unrealistic. This feeling of pressure can come from within themselves, from other people, or both. Sadness, depression, guilt, fear, and anxiety are all normal parts of learning to cope with major life changes, and a cancer diagnosis is a major life change. Trying to ignore these feelings or not talking with others about them can make the person with cancer feel lonely. It can also make the emotional pain worse. And some people feel guilty or blame themselves when they can’t “stay positive,” which only adds to their emotional burden.

Along these same lines, many people want to believe that the power of the mind can control serious diseases. This is a comforting belief that can make a person feel safer from the risk of serious illness. If it were true, you could use your mind to stop the cancer from growing. But the down side of such beliefs is that when people with cancer don’t do well, they may blame themselves.

To learn more about attitude and survival, researchers looked at the emotional well-being of more than 1,000 patients with head and neck cancer to find out whether it affected survival. Over time, those who scored high on emotional well-being showed no differences in cancer growth or length of life when compared to those with low scores. Based on what we know now about how cancer starts and grows, there is no reason to believe that emotions can cause cancer or help it grow.


metastasized lung cancer cells

Can psychotherapy help people live longer?

Research in the area of therapy, stress reduction, and cancer has come up with mixed findings. This can confuse reporters and patients alike. For example, a research study done in 1989 by David Spiegel and colleagues seemed to link a difference in survival with taking part in a support group. But other researchers who did the same kinds of studies did not have the same outcomes.

A 2004 study review pooled the results of many well-designed studies of cancer patients getting psychotherapy. With more than 1,000 patients in the final results, no effect was found on survival.

In 2007, other researchers looked at all the previous studies. They found that no randomized clinical trial set up to look at survival and psychotherapy has shown a positive effect, except in cases where medical care was a confounding factor. (This means that one group’s medical care could have been different enough to affect the results.)

Finally, Spiegel himself tried to repeat the 1989 study with a new group in 2007 to see if the result would be the same as that of their earlier trial. The 2007 study reported better quality of life among those who took part in the group, but there was no difference in survival.

In the last few decades, research has further shown that giving cancer patients information in a support group setting helps reduce tension, anxiety, and tiredness (fatigue), and may lower the risk of depression. Some other studies have shown that supporting cancer patients in keeping doctors’ appointments and teaching them about their treatment may help patients follow their treatment plan. While keeping doctors’ appointments and taking cancer treatment medicines as prescribed may help people live longer, this type of support is more medical and practical rather than mental health care.

It seems clear that support groups can affect quality of life, but the available scientific evidence does not support the idea that support groups or other forms of mental health therapy can help people with cancer live longer.

Mental health treatment and emotional support

Cancer affects your body, but it affects your emotions and feelings, too. Mental health treatment that claims to alter tumor growth is not recommended as the only form of cancer treatment, nor should it be sought just because someone thinks it might prolong life. But mental health care and emotional support can help patients and their loved ones better manage cancer and its treatment. Talk to the members of your cancer care team about things you can do to help yourself through a cancer diagnosis and treatment. Sometimes it also helps to talk to other survivors who are going through the same things you are facing.

Your attitudes, emotions, and moods can change from day to day, and even from hour to hour. You may feel good one day and terrible the next. Know that this is normal and that, with time, most people are able to adjust to a cancer diagnosis and move forward with their lives. Some may need extra help from a support group or a mental health professional to learn to cope better. Find the strength and support you need to feel the best you can and have the best possible quality of life.

If you would like to visit a support group or talk to someone about the life changes and emotions you are going through, ask your health care team about the resources you can use at your hospital, doctor’s office, or clinic. You can also contact your American Cancer Society at  1-800-227-2345 FREE1-800-227-2345  to find out about sources of support that are available near you.

To learn more

More information from your American Cancer Society

We have selected some related information that may also be helpful to you. These materials may be ordered from our toll-free number or you can read them online.

Living with cancer

After Diagnosis: A Guide for Patients and Families (also available in Spanish)

Coping With Cancer in Everyday Life (also available in Spanish)

Talking With Friends and Relatives About Your Cancer (also available in Spanish)

Learning About New Ways to Treat Cancer (Call us or visit our Web site for more on treatments used for different cancer types.)

Guidelines for Using Complementary and Alternative Methods

Emotions and cancer

Distress in People With Cancer

Anxiety, Fear, and Depression (also available in Spanish)
......

No matter who you are, we can help. Contact us anytime, day or night, for information and support. Call us at  1-800-227-2345 FREE1-800-227-2345  or visit www.cancer.org.

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【首例 ex vivo体外手术】 Meredith Moore,44岁,09年诊断为晚期胰腺癌。肿瘤包绕大血管,无人敢做手术。接受了两年aggressive的放化疗后,她自己联系医生。2011年6月5日在哥大医院由日裔医生加藤(Dr. Tomoaki Kato)操刀,3班轮替,20小时,世界首例ex vivo体外手术成功。她的胰腺肝脏胆囊胃脾和部分肠道被切除移出体外,剔除肿瘤后再将肝脏和肠道移植回体内。Moore存活至今。 http://www.nydailynews.com/life-style/health/woman-marks-anniversary-unusual-surgery-article-1.1309785



Meredith Moore and Dr. Tomoaki Kato


孙露: 心醉




 
 

所有跟帖: 

乐观性格很好.但是癌症真的不是只眷顾不乐观者.它有风险因素也有"随机性". -闽姑- 给 闽姑 发送悄悄话 闽姑 的博客首页 (0 bytes) () 09/17/2013 postreply 08:41:44

谢谢分享,回来真好。 -小解放军- 给 小解放军 发送悄悄话 小解放军 的博客首页 (131 bytes) () 09/16/2013 postreply 21:03:17

谢谢!很喜欢读你的文章,也非常敬佩你.注意休息,祝福你. -闽姑- 给 闽姑 发送悄悄话 闽姑 的博客首页 (0 bytes) () 09/17/2013 postreply 08:23:23

这种所谓研究多得数不清,今天这样说,明天那样说,没什么意义。 -sfap- 给 sfap 发送悄悄话 (0 bytes) () 09/17/2013 postreply 06:12:46

是,设计严谨的研究才有意义和比较有说服力.愿所有研究者及文章更加认真/严谨. -闽姑- 给 闽姑 发送悄悄话 闽姑 的博客首页 (0 bytes) () 09/17/2013 postreply 08:27:31

很有意义的调查研究 -TBz- 给 TBz 发送悄悄话 TBz 的博客首页 (64 bytes) () 09/17/2013 postreply 09:19:46

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