The theory that changing mental state can affect the course of cancer has been popularized by authors such as Bernie Siegel and Deepak Chopra. A support group program called Exceptional Cancer Patients (ECaP), developed by Dr. Bernie Siegel, was evaluated in a matched cohort study. Thirty-four women with breast cancer attending the ECaP program were matched 1 :3 with comparable patients identified from tumor registries. At 10 years of follow-up, there were no differences in survival between the two groups, with approximately 40% of patients in both groups alive at the end of the study.30
Several other studies, however, appear to show survival advantages in cancer patients receiving psychologic treatment. In the late 1970s, David Spiegel conducted a randomized trial that aimed to examine the effects of a psychosocial support group on quality of life and symptoms in women with metastatic breast cancer. As a post hoc analysis, the investigators looked at survival differences and reported a statistically significant prolongation of survival in the group receiving psychosocial support.31 This trial has been extremely widely publicized and extensively cited, despite an unplanned survival analysis and subsequent randomized replications that failed to support Spiegel's results.32,33
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