responsive to more extreme stress, may also function as a tumor promotor. Reducing prolactin secretion might reduce tumor promotion in vivo, although this has yet to be shown. Cortisol itself is an inhibitor of the cellular immune response.
Although the evidence in each of the areas examined is imperfect and contains examples of failure to confirm, there are numerous studies suggesting that suppression of negative affect, excessive conformity, severe stress, and lack of social support predict a poorer medical outcome with cancer. Conversely, social support, especially that which enhances a patient's sense of control and assertiveness, seems to improve outcome. Possible mechanisms include reductions in neuroendocrine stress responses. There are serious questions about whether immune functioning plays a substantial role in the progression of metastatic cancer. Social support may extend survival in fairly mundane ways by improving patterns of diet, exercise, sleep, and utilization of health care services. On the other hand, it may also be transduced in the brain into better modulated stress responses and perhaps better immune function. There is sufficient evidence to merit further investigation into the interaction between body and mind in coping with cancer. Although it is far too soon to apply the Cartesian dictum "I think therefore I am" to this problem, it is high time we recognized the interaction between thinking and physical being: I think and I am. Furthermore, the evidence allows the inference that two heads are better than one.
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