Optimism Deserves More Attention in Oncology

In an interview with Sarah DiGiulio in Oncology Times​, Hermioni L. Amonoo, MD, MPP, the Carol C. Nadelson Distinguished Chair in Psychiatry at Brigham and Women's Hospital and Assistant Professor of Psychiatry at Harvard Medical School, was asked "How are these positive psychology constructs related to cancer outcomes or other disease outcomes?"

Hermioni responded, “Positive psychological well-being constructs, such as optimism and its links with clinical outcomes, have been extensively studied in patients with other chronic diseases. If you look in the cardiovascular literature, there's very clear evidence that positive psychological well-being is associated with important clinical outcomes, including better quality of life and less cardiovascular mortality. Specifically looking at optimism, there's evidence that having more of it is associated with less stroke mortality, less cardiovascular mortality, and in some cases, better quality of life.

“One potential mechanism underlying these associations between positive constructs and clinical outcomes in patients with chronic diseases is behavioral. We know that patients who have high levels of positive psychological well-being constructs are more likely to engage in healthy behaviors, such more physical activity, treatment adherence, and smoking cessation. They are also more likely to make better dietary choices. All of these health behaviors have well-established links to better clinical outcomes.  

“The evidence is not so vast in oncology populations. Some of our work has tried to characterize this. In a systematic review to determine the association of positive psychological constructs and outcomes in patients with hematologic malignancies who have undergone stem cell transplantation, we found that optimism and positive affect were associated with improved quality of life (Biol Blood Marrow Transplant 2019; doi: 10.1016/j.bbmt.2018.09.030).

“Other initial qualitative studies have shown that, even in the midst of a cancer diagnosis and intensive treatment, patients do experience these positive emotions (Psyco-Oncol 2019;28:1633-1639). Our current work is trying to establish how interventions that increase these positive psychological well-being constructs are feasible and could potentially impact clinical outcomes in vulnerable oncological populations."

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