Wednesday, March 18, 2009

When hope heals

From Ode magazine:
An experiment: Two groups of rats receive transplants of malignant tumors and are given electric shocks. One of them can avoid the shocks by pushing on a lever; the other can't. In the group that can avoid the shocks, the immune system does its job, counterattacks and eliminates the cancer cells in 64 percent of the animals. In the other group, animals soon get discouraged, the immune cells are paralyzed and the cancer spreads in a few weeks. Only 23 percent of the rats reject the tumor.

Is that why Paul died—because he suddenly felt powerless to escape the "shocks" he got from his disease? [Paul, who had managed his illness for years, died 2 years after being told he had 2 years to live.] Cancer seems to develop faster and more aggressively in patients who have less control over the inevitable stress of existence, which seems to be one of the reasons support groups prolong survival. Now what could be more stressful than being told there's no hope of a cure? At the University of California, Los Angeles, Assistant Professor Steve Cole demonstrated that among AIDS patients on tri-therapy, the treatment benefits those who remain calm facing life's difficulties far more than those who have trouble controlling their stress. In the latter group, the virus spreads four times as fast.

But who will explain that to patients? Almost every week I hear patients tell me how they've received "death sentences" from their oncologists. These pronouncements are made with the greatest confidence, as if statistics were certainties. Studies like Cole's are almost never mentioned. Yet patients really need them. Because I've already made this mistake myself, I suspect doctors are more afraid of giving false hope than of talking about the worst that can happen. To guard against this Western-style voodoo, patients often need to know more than their doctors about what they can do to help themselves—beginning by placing more hope in their bodies than medicine is prepared to give them.
What role does hope play in addiction? An large role, I suspect. Scott Miller has found that expectancy accounts for 15% the variance in treatment outcomes.

“If you want to treat an illness that has no easy cure, first of all, treat them with hope” -- George Vaillant

1 comment:

Lou said...

I wonder about the hope of loved ones of the addict. How much, if any, difference that makes in their recovery.
I've heard addicts say they were helped by knowing one person would never give up on them.