Fisch pointed out that probably only 5 percent of head and neck cancer patients ever enter a phase III clinical trial, and those that do are likely to already have more social and medical support than their peers. In other words, they came into the study with an advantage which would make data based on their reported attitudes difficult to generalize to other cancer patients.
Fisch favors a concept he calls "rooting styles" -- comparing the way people approach cancer with the way they root for a sports team. Some are diehard, never-say-never fans, and others may allow for the possibility of losing a game or a season, but both fans are backing the same team.
"Some people have a style where they are optimistic. Some have a style where, if you ask them what they think the outcome will be, they are less certain. They have a coping style that is not a positive-attitude coping style, but it keeps them edgy and works for them," said Fisch.
In fact, Fisch added, trying to encourage a person with a less positive way of talking about their cancer to think more positively would just cause them more stress. That's what he calls the "tyranny of the guilt systems," where others imply that a patient has some mental control over their cancer's outcome.
Clashes between different rooting systems can become a challenge when families or couples have different styles, Fisch said. The key is to find what works for the patient and support that.
For advice on talking to someone diagnosed with cancer, head to the American Cancer Society.
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