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To the Editor.—
A recent article in The Journal by Derogatis et al (242:1504, 1979) explored survival time and psychological coping mechanisms in patients with metastatic breast cancer. I would like to comment on the following two aspects of that work: the scientific validation system employed for the resulting conclusions and an evident bias system that influences interpretation of data. The growing concerns of holistic medicine and implications that psychological factors are inherent both as causal as well as life-adaptive factors in cancer require that extreme caution in methodology and interpretation be maintained.The first question to be raised is whether the short-term survivors and the long-term survivors in the research experience are similar at the point of entry into the study. Although we are informed that the two groups are similar by statistical null hypothesis in regard to age and disease-free interval after their mastectomy, the mean age of
Melvin J. Krant. Coping Psychologically With Breast Cancer. JAMA. 1981;245(1):31–32. doi:10.1001/jama.1981.03310260015013