Mind-body research in psychooncology

The biomedical model of disease, though powerful, does not explain all known facts about cancer. It is argued that a broader theoretical framework which includes psychosocial factors is needed. There is empirical evidence that a hopeless/helpless coping style is associated with unfavorable disease outcome in patients with certain cancers. The converse, namely a link between an active, fighting spirit coping style and favorable disease outcome, is under-researched and less clear-cut. The delineation, measurement and psychophysiology of positive states of mind have been sorely neglected. This is a promising area for future research. Psychobiological mechanisms of possible relevance to cancer are considered in terms of psychoneuroimmunology. Despite formidable theoretical and methodological problems, some progress is being made. Recent evidence indicates that psychotherapeutic intervention can augment natural killer cell activity and lymphokine-activated killer cell activity in patients with malignant melanoma and with locally advanced, nonmetastatic breast cancer respectively. These challenging findings, if confirmed, have major implications for our understanding of mind-body interactions in patients with cancer.