Can Psychotherapy Cure Cancer?

‘I've come to realise that as physicians we're trained to make diagnoses and prescribe medications, but we need to really spend a lot more time studying how people heal. That's what I'm very interested in—these people beat the odds.’*

Dr. Jeff Rediger

‘What I was hearing was that ‘it's emotional’. So much of a radical remission is mental and emotional. To me, it just comes down to the absolute fact that the mind and body are 100% connected. Science knows that, we've known that for over fifty years.’ 

Dr. Kelly Turner

Dr. Jeff Rediger and Dr. Kelly Turner have both studied people who experience ‘spontaneous’ remissions of chronic diseases—specifically cancer. If you’ll forgive the hyperbole of this article’s title, I’m going to look at efforts to document whether psychotherapeutic approaches can prolong survival time for people with cancer. What specifically interests me, is why this seems like a very easy and very hard question to answer—depending on how it is approached.  

One quick note: when I refer to ‘psychotherapeutic approaches’ I’m meaning any approach that aims to bring healing or wholeness to the mind. I’m not limiting the category specifically to the tradition of western psychotherapy. 

Our story starts in 1989, when Dr. David Spiegel published a study in the Lancet, looking at the benefits of support groups for women going through breast cancer treatment. Perhaps predictably, he found that groups brought psychological benefits, lessening stress and depression. Less predictably, the participants ended up living a full eighteen months longer than the control group. At thirty seven months as compared to nineteen, that represented a near doubling of lifespan.

Stop the presses! That’s incredible. What makes it all the more so is that participants only received an hour and a half of group therapy per week—a fairly minimal dose. The possibilities of where to go from there seem endless. David Spiegel himself wrote of his shock at seeing such results.

There is a plausible mechanism for this. Various studies have found that adverse childhood experiences increase the risk of chronic disease in adult life. There are confounding factors here; for example abused children are more likely to engage in unhealthy addictive behaviours, such as smoking, drinking and not eating well. Studies have controlled for this however and found the association was still present. 

It therefore stands to reason that if psychological factors can be linked to causing cancer, psychotherapy could be used to treat it. 

Disappointingly, further studies were mixed in their findings and increased survival time could not be reliably replicated. It’s not that they never did, in fact it’s probably worth reading some conclusions.

A 1993 study on a 6-week structured psychiatric group for malignant melanoma concluded that:

‘Psychiatric interventions that enhance effective coping and reduce affective distress appear to have beneficial effects on survival’.

Whilst a 1999 study on psychotherapeutic support for gastrointestinal cancer patients said:

‘The results of this study indicate that patients with gastrointestinal cancer…benefit from a formal program of psychotherapeutic support in terms of survival.’

However others, including Dr. Spiegel’s own effort, failed to find any effect on survival rates. Spiegel speculated that this might be down to an improved emotional climate for breast cancer patients, which would nullify the effect of the group. I do think a substantial mystery as to why the effect appeared and disappeared remains, however, it’s not something I’ve been able to satisfactorily answer.   

***

One interesting observation was made by the lead author of a 1998 study that failed to find survival benefit. Dr. Alexander Cunnningham—himself a cancer survivor—noticed that a small number of study participants who received additional psychological support did survive significantly longer.

Now, this could just be a cherry-picking of data, but Dr. Cunnningham believed it was worth pursuing further.

He specifically observed that seven women in the intervention group lived significantly longer; with two of them still being alive eight years later - apparently in remission. Cunningham found that these seven:

‘Actively sought out other approaches to healing in addition to the therapy that

everyone else participated in…They reported intensive meditation, dedicated yoga practice, journaling, intentional gratitude, and more. Basically, they exhibited not only a pattern of taking responsibility for their own treatment but also a willingness to radically change habits, routines, and even the larger scaffolding of their lives.’

Dr Cunningham then ran three further studies zooming in on people engaged in a higher level of ‘psychological work’ regarding cancer. This time he found a significant relationship between ‘involvement in self-help and survival duration’.

As he zoomed in even further, he focused a study on nine people whom he classified as ‘highly involved’, engaging in some sort of spiritual or psychological process every day. 

Of those nine, eight enjoyed a high quality of life and lived at least two years beyond their original prognoses, with two experiencing complete and unexpected remissions of their cancer.

Cunningham found that the opposite was also true, with people who were unengaged in a psycho-spiritual process, either because they didn’t believe it would help or because they struggled with feelings of unworthiness, had a lower quality of life and lived only a third as long as the highly engaged group.

I’ll quote Dr. Jeff Rediger’s book, Cured,  where he summarises the differences between the two groups:

Conditions associated with poor survival outcomes were:

Inflexibility associated with low self-esteem or fixed worldview

Skepticism about self-help techniques, or a limited ability to apply

them

Meaning was habitually sought outside the individual, from some

external source

Strong, contrary views about the validity of spiritual ideas

Whereas Conditions associated with longer survival were:

Strong will to live

Actual changes in habits of thought and activity

Relaxation practices, meditation, mental imaging, cognitive monitoring

Becoming involved in a search for meaning in one’s life

Dr. Rediger identifies the fundamental nature of the problem, in that science is just not set up to ask the question in the right way. Commenting on Alexander Cunningham’s research, he writes:

‘But because such a small slice of subjects truly engaged in it, it was difficult—if not impossible—to get this across in the published studies. Studies, by design, look at averages, and the average results washed out the exceptional, making the effect of the interventions tested by Cunningham seem “minimal.” As hard as Cunningham tried, he still couldn’t overcome the core problem with traditional approaches to scientific studies—that their very design preemptively negates the exact question he was trying to answer. How you relate to the activity makes a huge difference and, as Cunningham found, designing a study that truly incorporates the degree of involvement of participants is almost impossibly difficult. It would rely entirely on selfreporting and transparency and would be subject to the vagaries of language and perception.’

A scientific approach involving randomised controlled studies certainly tells us something about something. It tells us that for the average person, there exists maybe some possibility of extending lifespan through support groups—although this is far from guaranteed. The nature of the approach however, may preclude it from asking the more important questions.

This hits the nail on the head as to why a ‘follow the science’ attitude may be the worst one to opt for.

***

This ultimately leads to more philosophical questions on the nature and meaning (or lack thereof) of disease. 

In her book, How to Starve Cancer, Jane McLelland documents her decades long journey in fighting her diagnosis by researching and experimenting with off label drugs. Beyond its value as a resource, the book is an incredibly inspiring read of dogged determination to fight the odds. 

When discussing her attitude to the disease, McLelland writes:

‘Did I ever “make peace” with my cancer? Did I learn “lessons” or feel it was a “gift”? I guess I am not afraid of it, if that is making peace. I learnt to live with it. I have learnt a lot about the human body, especially mine, and the various aspects of the disease. But making friends with it, being thankful for it? No. Never. Cancer was always the enemy.’

This passage is set in the wider context of a description of battle tactics employed by the Ancient Greeks to starve their enemies into submission, which can be repurposed for cancer.

In total contrast to this. We have the account of Shin Terayama, taken from Dr.  Kelly Turner’s book, Radical Remission: Surviving Cancer Against All Odds:

‘When I returned to my home, I tried to find the reason why I [was] suffering from cancer, and I [realized] I created this cancer myself. I created it because I worked so hard, and I didn’t sleep. I created it! So, I thought that cancer was my child. And I sent love to my cancer, and pain decreased and I could sleep fine. [The] next morning when I got up, my mind, my head, [my] brain was so clear that I didn’t use any painkillers. . . . So, I stopped [using] painkillers and instead of that, when I had pain, I [said], “Oh, thank you very much for saying you are hurting. I love you, my child.” I touched this [points to his kidney] and said to my cancer, “I love you, I love you, I love you.” And pain decreased! That’s why I sent love to my cancer always, from morning till night. . . . Unconditional love, that’s unconditional love. I said [to it], “Thank you very much for existing.”’

I’m not highlighting these contrasting positions to shame one and promote the other. Both of these people are alive and doing well decades after they should have been deceased. I am merely highlighting that such a fundamental contrast exists.  

I think that’s what I find interesting about this subject. At its foundations, we come down to philosophical choices between the qualitative and the quantitative, between fighting and reconciliation. Answering the very question of whether psychotherapy can cure cancer depends on value judgements about knowledge itself.

To step fully into the potential, however, I’ll conclude with a quote from Anita Moorjani, being interviewed on the Radical Remission Project’s Stories That Heal Podcast. Moorjani is perhaps the world’s most famous spontaneous remission cancer survivor. She emerged from the brink of death with insight into why she had become ill, and watched her tumour recede to nothing over the following weeks:

‘In 2002 I was diagnosed with lymphoma. At that time it was diagnosed as stage two, but over the course of the next four years it started to progress. It would go into remission and come back, and go into remission and come back. My body stopped absorbing nutrition because the lymphoma, the cancer, spread throughout my lymphatic system. 

‘I had tumors the size of golf balls from the base of my skull, all around my neck, under my arms, in my chest and all the way down to my abdomen. By this point, my lungs were filled with fluid. I couldn't lie flat because if I did, I would choke on my own fluid. My muscles had atrophied, so I could no longer walk, I had to use a wheelchair. I was always so tired and I couldn't breathe properly, so I had a portable oxygen tank which was connected through the tubes. I weighed about eighty five pounds. I had these open lesions where toxins were weeping through my skin. By February the 2^nd, 2006, I was so tired of living and fighting to stay alive that I just let go and I went into a coma. That was when the doctors told my family that I wouldn't even make it through the night.

‘But while I was in the coma I felt incredible. I was free from my body, and yet I felt alive. I felt better than I ever remember feeling in physical life before. So as soon as I made the decision not to come back, I started to understand why it was that I got sick in the first place. I started to understand how it was that every thought and every decision that I had made during my life had led to this point of me lying here in this hospital bed dying. So I understood what I had done to contribute to this situation. I started to understand that we are actually a lot more powerful than we've been led to believe. My soul was much more powerful than I had been led to believe my whole life. And I started to understand that now that I was knowing these truths, knowing the truth of what had led to my illness, and knowing the truth of how powerful we actually are, that if I chose to go back into my body, that my body would heal.

‘One of the biggest lessons I learned is that for me, cancer was not a medical problem, it was a spiritual problem. I am speaking for myself—but I  know a lot of people will relate.

‘The medical model may have been able to help me manage the symptoms, but the issue was not a medical issue, the answers were not to be found in medicine. It was a spiritual problem. It was a case of me not being and expressing who my soul came here to be. That's what I understood and that was one of the biggest things I learned.

‘As I lived by that principle, I saw my life change dramatically. So everything I did was according to that principle. I had to learn to love myself, which is something I had never done before. 

‘I had always been a people pleaser, I've always been non-confrontational, I've grown up in a culture with gender disparity where a woman's worth is only measured by how valuable she is to the men in her community. So, I've never loved myself. I've always beaten myself up. And I learned when I was on the other side that while we're taught to see God in everybody else's eyes, I was never taught to see God in my own eyes.

‘And so I started to realize that I am an expression of God. I am here for a purpose. My soul wants to express itself. And because I'd never allowed it to do all that, I had repressed myself. The cancer wasn't there to kill me. The cancer was my own body trying to communicate with me. It was trying to save my life.’ 

* Some of the quotations used in this article have been paraphrased for ease of reading.