Many people blame themselves when they are diagnosed with cancer ‒ but conditions like anxiety and depression do not cause tumors, a new study confirms.
“I’ve told patients that for years,” said Barbara Andersen, a distinguished professor and psychologist at the Ohio State University Comprehensive Cancer Center.
“There’s no one thing that causes cancer. There’s a myriad of factors,” she said. “If you think, ‘I did one thing wrong,’ it’s not it.”
It is, however, natural in the face of a serious diagnosis to look for a cause, said Michelle Jacobo, a clinical psychologist and director of psychology at the Dana-Farber Cancer Institute in Boston.
But attitudes and personalities don’t cause cancer and self-blame isn’t helpful.
“We don’t want them feeling that they hold more of a burden than they (already) hold,” she said.
What the study found
Anxiety and depression was suspected to increase cancer risk perhaps by influencing health-related behaviors or by triggering inflammation that fostered cancer development.
Some previous studies supported an association between depression, anxiety, and cancer incidence, while others found little or no link.
Researchers at the University Medical Center Groningen in the Netherlands looked at data from the Psychosocial Factors and Cancer Incidence consortium, which includes information from 18 previous studies, including more than 300,000 adults from the Canada, the United Kingdom, Norway and the Netherlands.
In a study published this week in the journal “Cancer,” they found no link between depression or anxiety and breast, prostate, colon or alcohol-related cancers over 26 years. Anxiety or depression did lead to a 6% increased risk for developing lung cancer and other smoking-related cancers, but most of that link disappeared when researches accounted for how much someone smoked.
“We hope our findings provde some relief and people don’t get stuck in the thought process, ‘maybe if I had had therapy sooner for my depression’ or ‘maybe if I had worked harder in my therapy,’ or ‘maybe just got myself out of bed or left the house’ this might not have happened to me,” said Lonneke van Tuijl, who helped lead the research and is now at Utrecht University in the Netherlands. “We don’t find evidence for that.”
Previous studies also have shown no connection between someone’s particularly bad year ‒ a divorce plus the death of a parent, say ‒ and a soon-to-follow cancer diagnosis, Andersen said. One study found no link between a parent losing a child, considered the most stressful of all events, and a future cancer diagnosis.
“The data is negative. It’s always been negative,” she said.
Fight depression after diagnosis
But plenty of research has confirmed a link between depression and survival once someone has been diagnosed with a life-threatening disease, Andersen said.
“Emotions following diagnosis are very very important and important to treat,” she said.
It’s not clear whether negative emotions mean someone is less likely to take care of themselves ‒ not taking medications, eating properly, sleeping well, exercising ‒ or whether the emotion itself drives inflammation which makes conditions like cancer and heart disease worse, she said.
The time between diagnosis and the beginning of treatment is typically the most stressful. “Things do improve once treatment starts,” she said, because something is being done to counter the disease.
People who have depression or anxiety before a cancer diagnosis may have a harder time getting out of a negative pattern of thought after diagnosis, Jacobo said.
Counseling can help people become more aware of any distorted patterns of thinking and “then pivot towards coping effectively,” she said.
What people can do to help themselves
People often struggle with the lack of control and uncertainty that comes with any serious disease. Jacobo tries to help them “sit with pain or fear differently.”
Being consumed by grief isn’t living, she said, and being judgmental only induces a harmful sense of shame. Instead, inspired by the Buddhist concept of mindfulness, she helps patients consider “how do I become less afraid of the feelings or thoughts and just let them be.”
Cancer patients shouldn’t think they have to be a positive warrior all the time, she said. It’s important to allow emotions like fear and grief to “come and go, just like the weather. You don’t want to fight it and say, ‘I’m not allowed to have a rainy day.'”
Finding a balance helps people cope the best, Jacobo said.
“You can be a warrior and cry. You can be a positive person and have fear. They don’t cancel each other out,” she said.
Jacobo tries to help people find meaning in whatever time they have left, be it weeks or decades. “This is the journey of our species. How do we do it in a way that’s compassionate and thoughtful and does lean on science?”
Contact Karen Weintraub at kweintraub@usatoday.com.
Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.
