American Family Children's Hospital

Cancer and the Mind: The Psychology of Diagnosis and Survivorship

Researchers examine impact of mental health on cancer survivorsMadison, Wisconsin -Scientists have long looked at the links between the body and the mind. While there is some evidence that one can affect the other, UW Carbone Cancer Center researchers are looking for ways to use these links to improve cancer care and patient well-being.


Erin Costanzo, PhD, a UW Carbone Cancer Center psychologist, studies how positive and negative emotions can play a role in the lives of cancer patients and survivors.


"There isn't a whole lot of proof that stress and depression contribute to the development of cancer," she explains, "but there are data showing those factors play a role once cancer has been established or diagnosed."


In a recent publication in the journal Health Psychology, Costanzo compares cancer survivors' reactions to every day stresses to those who never had cancer. To evaluate these differences, Costanzo and her colleagues at UW-Madison and University of Michigan and Penn State University culled information from a larger University of Wisconsin-based study called "Midlife in the United States" (MIDUS).


Every day, study respondents were interviewed about stressful events at home and at work as well as interpersonal tensions like an argument with a friend. They also completed assessments about their mood and physical symptoms for the day and provided a saliva sample for researchers to assess stress hormones.


Despite going through the stress of cancer diagnosis and treatment, Costanzo discovered that survivors generally responded to daily stressors in the same way as people who never had cancer at all. In fact, of the few differences Costanzo found, some pointed to cancer survivors coping more effectively to daily stressors than the general population. For example, while survivors interpersonal conflicts tended to have a greater negative impact on cancer survivors' day, they had less of a decrease in positive mood and less of an increase in stress hormones when other types of stressors occurred.


"On the whole," remarks Costanzo, "cancer survivors are pretty resilient. In some cases, they can even weather stressors and maintain positive emotions a bit better than those who have not been diagnosed with cancer."


Costanzo also looked at what happens when study participants decide to avoid arguments with others. Usually, she says, avoidance doesn't reduce stress. If person A gets angry with person B, for example, but doesn't say anything about it - person A will still feel an elevated level of stress. However, cancer survivors who avoid arguments report fewer bad feelings as a consequence.


These results, according to Costanzo, reaffirm previous research suggesting that the experience of cancer may deepen the value survivors place on their personal relationships. "Big blow-ups with loved ones really affect survivors," Costanzo adds, "but when they decide an argument isn't worth it, they are able to maintain their positive mood."


Examining data from large studies like MIDUS allows Costanzo to give patients in the cancer clinic real data on how to respond when they get down.


"Knowing close relationships are very important in this population also helps me validate their experience," she continues, "so I can provide them with the appropriate tools to cope."


For her part, Costanzo wants to keep studying the emotional make-up of cancer survivors in order to hone her own skills as a psychologist.


"People who maintain a high level of psychological well-being throughout treatment," she notes, "can give us clues on how to help future patients cultivate well-being and cope effectively with their diagnosis and treatment."


Date Published: 06/12/2012

News tag(s):  cancer

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