Is a Positive Mindset Necessary to Overcome Cancer?

Shannon Rollins, a Tennessee resident, has been free of HER2-positive breast cancer for three years, but her journey was far from easy. Her treatment plan spanned a full year and involved chemotherapy, a double mastectomy, and reconstruction surgery. While she aimed to stay optimistic most days, there were moments of struggle. "I managed to stay upbeat around others, but my family saw me at my lowest," she shares. "I often felt like a burden when I couldn’t think clearly or when my strength failed me."

Phrases like "keep a positive mindset" or "your attitude determines everything" are often shared with cancer patients. But does this mindset truly affect survival outcomes? Research shows that maintaining a positive attitude does not influence cancer survival rates, as stated by the American Cancer Society.

For example, a 2010 review of multiple studies examining whether optimism or a "fighting spirit" could boost cancer survival rates or prolong the lives of patients found no supporting evidence. In fact, assertions that "positive psychology" strengthens the immune systems of cancer patients were dismissed as unlikely and labeled "bad science" by the researchers. "We encourage positive psychologists to focus on evidence-based practices rather than unfounded optimism," the study authors concluded.

Moreover, placing the unrealistic expectation of constant positivity on patients can add to their emotional load, especially when they face natural feelings of anxiety, depression, and distress that often accompany cancer diagnosis and treatment. Another study indicated that an overemphasis on positive thinking might lead some to blame patients if they fail to recover.

Expecting cancer patients to stay positive at all times is impractical, particularly in the initial stages of diagnosis. "Cancer turns your life upside down," explains Elaine Smith, M.S., L.M.F.T., a behavioral health therapist at Cancer Treatment Centers of America (CTCA) Atlanta. She highlights the numerous stressors tied to a diagnosis, including emotional, financial, work-related, and family issues. "And looming over everything is the ultimate question: Will I survive?"

On a brighter note, maintaining a realistic and balanced positive outlook can help ease some of the challenges during the treatment process.

What Exactly Is a 'Positive Attitude'?

A "positive attitude" is often linked to constant happiness, cheerfulness, and always focusing on the bright side. However, for cancer patients, the idea is much more complex and layered.

"A positive attitude involves realistically assessing the situation with a balanced perspective, acknowledging both the good and the bad," explains Sara Kouten, a licensed clinical social worker and therapist, and founder of SafeWaters Therapy, which provides grief and trauma support for individuals facing cancer or chronic illnesses. "When my clients adopt a 'positive attitude,' they can separate the negative aspects and still find joy. They understand that happiness doesn’t require the absence of challenges," she adds.

Reaching a point where cancer patients can gracefully accept the highs and lows of treatment is no easy task. Many seek the help of specialized therapists to develop coping mechanisms. "A positive attitude is something you cultivate and strive for," says Smith. "It’s rooted in hope, and patients shouldn’t feel guilty if it fluctuates daily."

The Real Role of Positivity in Cancer Treatment

While positivity won’t eliminate cancer cells, it can foster a mindset that supports patients during their journey, encouraging adherence to treatment plans and medical advice. "A positive outlook helps people accept reality, find hope, and stay committed to their treatment," says Kouten.

The Mayo Clinic highlights that a positive mindset can motivate patients to stay physically active, maintain connections with loved ones, and engage in social activities, all of which can enhance their well-being during and after cancer treatment.

Rollins, a former cancer patient, shares this perspective. "I focused on finding the silver linings. It wasn’t always easy, but I made the best of it," she says. For example, she cherished the quality time spent with friends during long chemotherapy sessions. She also joined a support group through the Red Door Community, founded by actress Gilda Radner.

Nurturing Positivity During Cancer Treatment

At CTCA, Smith avoids using the term "positive" with her patients, instead fostering an "environment of hope." Therapists at CTCA equip patients with skills to navigate treatment while focusing on one day at a time. Patients are guided to set daily goals, practice gratitude, and concentrate on the present, as many future concerns are either beyond their control or unlikely to happen. "We tackle one hurdle at a time," Smith explains.

One of the key strategies Smith teaches her patients is mindfulness. "It’s a powerful technique rooted in relaxation and controlled breathing," she says. This practice helps individuals "free themselves from a wandering mind," which often fuels fear and depression.

Mindfulness can be easily practiced at home and doesn’t require much time. Smith recommends starting with two daily sessions, each lasting just five minutes. She advises searching for "mindfulness breathing exercises" on YouTube or using apps like InsightTimer. During the exercise, sit comfortably, close your eyes, and focus on your breathing.

"When an unwanted thought arises, visualize it floating away on a cloud or drifting down a stream, then return your focus to your breath," she explains. "The thought itself isn’t the issue; it’s dwelling on it that causes problems." Initially, many patients doubt the effectiveness of this meditation technique, but Smith notes that it has been proven to alleviate anxiety, depression, sleep issues, and pain.

It’s also essential for cancer patients to have a healthy outlet for expressing negative emotions. According to Kouten, these feelings are "valid and real, and they need to be expressed (appropriately) to process them and transition to more positive emotions." Journaling and talk therapy are effective methods for this purpose.

If someone struggles to maintain hope, it’s crucial to discuss this with their healthcare team. Depression, which impacts 15 to 25 percent of cancer patients, can be debilitating and often requires intervention. Many cancer centers, including CTCA, provide specialized programs and services to support patients throughout their journey.

Rollins has been free of cancer for three years. While she continues with regular check-ups and medication, she considers herself fortunate to have moved past the disease, with cancer becoming a distant memory.

"After finishing treatment, I chose to shift my focus away from cancer and toward adventures and living life to the fullest," she shares. "I’m grateful that cancer no longer dominates my daily life."