Talk delivered at European Health Psychology Conference, Crete Sept 2011

1. Psychoneuroimmunology of Cancer: Tooth Fairy Science? James C. Coyne, Ph.D. University of Pennsylvania School of Medicine and University Medical Center, Groningen jcoyne@mail.med.upenn.edu

9. Claims That Stress Predicts Incidence, Progression, Outcome of Cancer

14. Claims That Psychosocial Interventions Promote the Survival of Cancer Patients...

16. Coyne JC, Stefanek M, Palmer SC. Psychotherapy and survival in cancer: the conflict between hope and evidence. Psychol Bull. 2007;133:367-394. No trial has ever found that psychotherapy improved the median survival time of women with metastatic breast cancer. No trial in which survival was chosen as the outcome of interest ahead of time has demonstrated a survival effect for patients with any type of cancer, when psychotherapy was not confounded with improved medical surveillance or treatment.

18. “ The results suggest that we can help breast cancer patients make positive steps that may help them live longer and make recurrence less likely. We already knew a psychological intervention program could help breast cancer patients to handle their stress, function more effectively, and improve their health. Now we know it does even more. ” Andersen, B. L., H. C. Yang, et al. (2008). "Psychologic Intervention Improves Survival for Breast Cancer Patients A Randomized Clinical Trial." Cancer 113(12): 3450-3458.

20. Psychosocial Intervention, Immune Function, and Progression of Cancer: Unproven Medicine

21. Weak or no effects, but positive results emphasized, strong confirmatory bias in reporting new results and recounting of past studies. Doubtful clinical significance even if results were obtained. Confused, simplistic view of role of immune system in cancer progression. Claims That Psychosocial Intervention Strengthens the Immune System

22. Miller GE, Cohen S. Psychological interventions and the immune system: A meta-analytic review and critique. Health Psychology. Jan 2001;20(1):47-63. Each of the measures used in this literature represents only a small facet of a complex, highly redundant system. It would therefore be inappropriate to conclude that intervention-related changes in any specific immune parameter signal a state of "immune enhancement" or altered susceptibility to immune-mediated disease. The normal functioning range for most immune measures is very broad, and psychological interventions typically do not induce changes of sufficient magnitude to move people outside of these boundaries (p. 48).

26. The ultimate tooth fairy science study?

36. “… and seldom is heard a discouraging word” All the positive results that fit. No negative PNI findings acknowledged.