Psychosocial Variables and the Course of Cancer

The data reported by Cassileth et al. (June 13 issue)¹ provide potentially valuable information on the importance of psychosocial factors in surviving advanced malignant disease. I do not agree, however, that this study supports the conclusion, as the authors state, that "the inherent biology of the disease alone determines the prognosis...." The seven factors used to construct the psychosocial index were selected because of their association with survival or longevity in previous studies that were conducted, for the most part, in selected healthy populations.