The association between treatment-specific optimism and depressive symptomatology in patients enrolled in a Phase I cancer clinical trial

BACKGROUND. Previous research has found that cancer patients often overesti mate the likelihood that they Mill achieve a positive response in Phase I t rials. However, maintaining optimistic expectations may help patients cope with a poor prognosis and uncertain outcome. The authors prospectively exam ined the association between treatment-specific optimism and mental health among patients participating in a Phase I/b trial. METHODS. Twenty-four patients with metastatic renal cell carcinoma and 22 p atients with metastatic melanoma completed an assessment battery at the beg inning of treatment and 3 weeks later, on the final day of treatment. Patie nts completed measures of treatment-specific optimism (e.g., beliefs regard ing the treatment working), depressive symptomatology, mood disturbance, an d overall distress. RESULTS. The majority of patients believed that the treatment would either cure them (87%) or stop cancer progression (85%), Regression analyses revea led that the level of treatment-specific optimism (e.g., "The treatment I a m receiving may cure me") was associated negatively with baseline measures of depressive symptoms (P < 0.006), mood disturbance (P < 0.001), and sympt oms of distress (P < 0.0001) after controlling for age, number of metastase s, and time since diagnosis. Patients with symptoms of clinical depression at baseline reported significantly lower levels of treatment-specific optim ism than patients without symptoms (P < 0.03). Treatment-specific optimism also was associated negatively with symptoms of depression at the end of tr eatment (P < 0.003), controlling for symptoms of depression at the beginnin g of treatment. CONCLUSIONS. The results of the current study suggest that high levels of t reatment-specific optimism are associated with better mental health outcome s at both the beginning and end of treatment.