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Researchers at the University
of Pennsylvania School of Medicine concluded – after
an extensive research review – that there is no compelling
evidence linking psychotherapy or support groups with survival
among cancer patients. |
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Researchers found that previous studies had
numerous methodological and analytical flaws, including the fact
that they were not designed to test the hypothesis that psychotherapy
extends the lives of cancer patients. |
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The paper appears in
the May issue of the Psychological Bulletin. |
(PHILADELPHIA) – Previously-published research has given
credence to the notion that psychotherapy extends
the lives of people with cancer.
In fact, one in four cancer patients believe that science supports
the idea that participating in group
therapy will extend their lives. However,
in a paper appearing in the May issue of the Psychological
Bulletin, researchers
at the University of
Pennsylvania School of Medicine concluded – after
an extensive research review – that there is no compelling
evidence linking psychotherapy or support
groups with survival
among cancer patients.
“We all wish that psychotherapy could prolong life, because
it appeals so strongly to firmly-rooted notions that a person should
be able to control their destiny,” says lead author, James
C. Coyne, PhD, Co-Leader, Cancer
Control and Outcomes Program, Abramson Cancer Center and Professor of Psychology in
Psychiatry at Penn. “We have a special responsibility
to cancer patients to clarify that the reasonable goal of psychotherapy
and support groups is to improve their quality of life, not extend
it.”
Two studies in particular – Spiegel
et al., 1989 and Fawzy
et al., 1993 – have been widely interpreted as providing
early support for the idea that psychotherapy promotes survival
among cancer patients. However, the authors report that the
studies had numerous methodological and analytical flaws, including
the fact that they were not designed to test the hypothesis that
psychotherapy extends the lives of cancer patients. The study investigators
had redefined the purpose of their studies after looking at their
data – a practice that is generally not acceptable in biomedicine
and that often leads to claims that will not be validated in subsequent
studies.
Coyne notes, “If these studies had been testing medications,
rather than psychotherapy, no one would have paid much attention
to the redefined outcome of improved survival, and leading medical
journals would probably not have accepted the papers, given their
other flaws.”
In the years following these studies, additional studies have
been conducted to test for the effect of psychotherapy extending
the lives of cancer patients, but none have demonstrated a survival
benefit that could logically be attributed to psychotherapy. In
biomedicine, a large-scale trial would not be considered warranted
for cases in which a hypothesis was interesting but improbable
given the available data. Therefore, the authors conclude
that there is not enough basis to justify investing additional
funding for research in this area.
Additional authors of this research review are Steven
C. Palmer, PhD, Abramson
Cancer Center of the University of Pennsylvania and Department
of Psychiatry; and Michael
Stefanek, PhD, American
Cancer Society.
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