Staying positive

"Stay positive." It’s a common piece of advice given to people with cancer and their carers. But how do you stay positive in the face of such a difficult situation? And is it really so important to be positive?

What does it mean to stay positive?

What "staying positive" means depends on who you ask. Often patients and their carers define being positive as not letting the cancer interfere with their daily lives, or not talking about cancer or about the emotional effects of a cancer diagnosis.

However, oncology nurses and other health professionals encouraging patients to be positive usually mean something else – like taking on attitudes of hope, acceptance, a fighting spirit and looking on the bright side.

Hope can mean different things at different times. For example, a patient in the early stages of cancer is likely to have hope for a cure; a patient with advanced cancer may instead hope to minimise pain and to have an opportunity to spend quality time with friends and family.

Whatever the definition, it is important to recognise that your own understanding and expectation of ‘hope’ or ‘being positive’ may be different from the person that you are caring for.

Can being positive affect the likelihood of a cure?

It has been suggested that having a positive attitude can lead to either extended remission or a cure. Vast numbers of self help books also place responsibility for illness on the person who is sick, particularly when medical science is often unable to explain the causes of cancer.

However, there is no evidence that this is thinking either positively or negatively will influence the outcome of your disease, and research has indicated that a "fighting spirit" has no significant association with either survival or recurrence (Petticrew et al 2002; Watson et al 2005; Schofield et al 2004).

Moreover, if a patient tries to stay positive but does not go into remission, they can feel a sense of failure – like they have not tried hard enough and therefore the cancer is somehow their fault. In his book Time on Fire, the actor Evan Handler described his sense of failure when he had a recurrence of leukaemia in spite of his best attempts at changing his outlook.

Why be positive then?

If maintaining hope won’t necessarily affect medical outcomes, then why be positive? First of all, positive thinking may make it easier for people to cope in difficult situations. Perhaps not surprisingly, people who say they are optimistic report a better quality of life in the face of adversity than those who do not.

Secondly, many cancer patients find that after a cancer diagnosis, the loss of control and disruption to life can be overwhelming.

Being positive, or at least the attitude taken towards having cancer and caring for someone with cancer, is one thing that is chosen, and having a sense of control has been shown to reduce depression in people with cancer.

For the carer, hope is crucial in the coping process. Hope can provide the carer with a sense of purpose and meaning. For some, it also brings a sense of happiness in what they do, and comfort to the person they care for.

Hope can help minimise the stress and fear of caring for someone with cancer and can enhance feelings of trust and togetherness. Hope can help you get through those times when they feel they can't go on, when they are tired and exhausted.

Expressing your feelings – even when they’re not positive

The pressure on cancer patients and their carers to think positive and to maintain hope can be a burden at times. It can keep people from expressing their true feelings, and can even make it difficult for them to talk about and plan for things that are confronting, such as palliative care or dying.

In reality though, acknowledging the possibility of adverse outcomes does not need to be incompatible with maintaining hope.

If you’re feeling sad, angry, anxious or stressed, don’t ignore those feelings. Try to talk to someone, and gradually remind yourself of positive and hopeful things.