has studied the effect of mental states on the progression

of disease, and ultimately on survival. Many psychosocial

variables have been identified for study.

 The role of psychosocial variables in the development

of cancer has been the object of many reports in the

professional literature. Several variables are repeatedly

noted in these reports as being characteristic of persons

who develop cancer. They include loss of a significant

relationship, major life change, depression, hopelessness,

and restricted hostile or aggressive expression (Bahnson &

Bahnson, 1964; Greene, 1966; Kissen, 1963; LeShan, 1966;

LeShan & Rezikoff, 1960; LeShan & Worthington, 1956).

 Although the tone of discussion in many of these

reports suggests that the findings support such a

relationship, there is no direct evidence of a relationship

between psychosocial variables and the development of

cancer. These reports are characterized by serious

methodological problems that call into question any other

conclusions. The primary methodological problems concern

the failure to control for important epidemiologic factors,

the failure to consider important differences between

patients with various cancer types, and the reliance on a

retrospective design (Wellisch & Yager, 1983).