B. Garssen et K. Goodkin, On the role of immunological factors as mediators between psychosocial factors and cancer progression, PSYCH RES-N, 85(1), 1999, pp. 51-61
Thirty-eight prospective studies on the role of psychological factors in ca
ncer initiation and progression are reviewed. Despite the availability of m
any prospective studies, there is no certainty about the role of any specif
ic factor. An important reason might be that the interactions among several
psychological factors, and the interactions of psychological and biomedica
l risk factors, have rarely been studied. Some evidence has been found that
a low level of social support, a tendency towards helplessness, and repres
sion of negative emotions are factors that promote cancer progression. The
effect of psychological factors has been more convincingly demonstrated wit
h respect to cancer progression than cancer initiation, and more convincing
ly in intervention than in natural history studies. Possible mechanisms med
iating associations between psychological factors and disease outcome are d
iscussed. The role of immunosurveillance seems modest overall, and alternat
ive pathways are suggested. (C) 1999 Elsevier Science Ireland Ltd. All righ
ts reserved.