Previous chapter: 2. The psychosocial situation

3. What effect do words have?

The psychological situation of cancer patients described above makes it clear that generally the combined effect of lay perceptions of cancer, the actual suffering caused by the illness and its therapy, and the influence of doctors can be responsible for severely negatively affecting the patient at a time when he is still full of life and does not need to think about dying any more or any less than patients with angina pectoris, after a heart attack, with pneumonia, undergoing dialysis treatment, or suffering from rheumatism or dementia.

However, specifically with respect to cancer patients, the wrong words or gestures can unnecessarily aggravate problems with the illness. In the particular situation of a cancer patient, well-intended doctor’s expressions of sympathy such as "You will not get through the therapy without taking psychopharmaceuticals" and "Bad luck seems to follow you!", or terms such as "incurable", "far advanced", "dying" and "death" are often self-fulfilling prophecies.

The reason is that the course of the illness depends on the psychological disposition of the patient. Particularly due to work by the German sociologist Grossarth-Maticek it is now possible to quantify the influence of emotional components on the course of cancer. After major epidemiological studies with thousands of patients and healthy controls spanning more than 20 years, Grossarth-Maticek and colleagues determined that psychological factors affect the risk of cancer to a similar extent as physical risk factors including genetic predisposition: People with a favourable psychological profile are afflicted by cancer less often than patients with an unfavourable psychological profile. If members of the former group do get cancer nonetheless, they continue to live for longer than the psychologically disadvantaged patients. There may be a correlation with more physical exercise among those with a favourable psychological profile: It is known that sport activities can prevent relapses and prolong life expectancy better than any other single measure.

Among others Grossarth-Maticek and his colleagues (ref 1-3, 15, 16 or recent Japanese research, ref. 13, 14) showed that the course which the disease of cancer follows is particularly affected by the following psychosocial factors:

generally depressive moods (reactive or endogenic)
anxiety
the feeling that external influences insurmountably restrict the person’s thoughts and actions ("I do not live myself, I am being lived. Other people determine my life. My life is manipulated from outside.")
experience of loss or frustration of all types
lack of support, lack of reassurance and lack of positive feedback from the social environment, including the doctor-patient relationship. ("My life does not mean anything to the people around me. I am only a burden to others.")
suppression of individual urges, desires, needs and attitudes to maintain a harmonious atmosphere. ("To keep the peace, I give in and don’t insist on my own way.")

These risk factors have an effect on many features of the lives of cancer patients and are thus relevant to the course of the illness. Some concrete examples for the interference of cancer specific issues with above risk factors include:

disappointed hopes of cure (aroused by the patient himself, by doctors or other trusted persons)
incapacity to work, loss of job, lowering of social status due to restrictions imposed by the illness
changing or non-existent (medical) close contacts, uncertain doctor-patient relationships that are characterised by crises in trust
death of a beloved family member or friend, particularly if due to cancer
unwanted divorce or other forms of separation from beloved persons
the feeling of being "useless", "superfluous" or even "undesired", "harmful" or "burdening". Associated with this: loss of self-esteem even to the point of detesting or rejecting oneself
anxiety (e.g. about dying, helplessness or the side-effects of therapy)

If the question from the title of this article is now posed, "Can words kill?", and these psychosocial risks are taken into account, we give the following answer:

Words and deeds of family members, friends, doctors and therapists which reinforce or favour these risks can indeed shorten the life of the patient.

Next chapter: 4. Can fatal words be avoided or neutralised?