6 The work of the Simontons. Simonton and Simonton (1975) are well known for
applying psychosocial factors and interventions for improving the quality of life of
cancer patients using a whole-person approach. This involves the following processes:
(1) relaxation, which aims to decrease muscle tension and therefore decrease pain;
(2) mental imagery, whereby cancer patients are encouraged to focus on something
positive (this aims to develop a belief in the ability to recover, therefore decreasing
pain, tension and fear); and (3) exercise programmes, which aim to increase the
sense of well-being. In 1975, Simonton and Simonton encouraged a positive attitude
towards treatment using whole-person approach among 152 cancer patients for 18
months, and argued that this intervention predicted a good response of treatment and
reduced side-effects. These methods are also currently being used in the Bristol clinic
in the UK.Adjuvant psychological therapy
Greer et al. (1992) suggested that, in addition to physical interventions, patients with
breast cancer should be offered adjuvant psychological therapy. This involves
encouraging cancer patients to examine the personal meaning of their cancer and what
they can do to cope with it (see Focus on research 14.2 opposite).Psychological factors in longevity
The final question about the role of psychology in cancer is its relationship to longevity;
do psychosocial factors influence longevity?Cognitive responses and longevity
Greer et al. (1979) carried out a prospective study in which they examined the relation-
ship between cognitive responses to a breast cancer diagnosis and disease-free intervals.
Using semi-structured interviews, they defined three types of responders: those with
‘fighting spirit’, those who showed denial of the implications of their disease and those
who showed a hopeless/helpless response. The authors reported that the groups who
showed either ‘fighting spirit’ or ‘denial’ had a longer disease-free interval than the other
group. In addition, at a further 15-year follow-up, both a fighting spirit and denial
approach also predicted longevity. However, there were problems with this study.
At baseline the authors did not measure several important physiological prognostic
indicators, such as lymph node involvement, as these measures were not available at the
time. These physiological factors may have contributed to both the disease-free interval
and the survival of the patients. More recently, Gidron et al. (2001) examined the role
of hopelessness defined as helplessness and pessimism in predicting changes in breast
cancer. Clinical data, measures of hopelessness, life changes and measures of affect
were collected at baseline from 49 Israeli women diagnosed with breast cancer. Follow-up
data was collected over a four-month period. The results showed that hopelessness was
related to aspects of mood. In addition, helplessness (not pessimism) predicted changes in
CA15-3, which was used as the marker for breast cancer development.344 HEALTH PSYCHOLOGY