People frequently ask the same questions about their cancer experience.

You may have asked yourself the same question as well. Here are some answers based on what we know, and what we don’t know.

Did my personality or emotions cause my cancer?

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Do certain personality traits, a history of adverse childhood experiences, or a particular way of coping with stress make a person more likely to get cancer and to die from it? Conversely, do other personality or coping patterns protect people from getting cancer or help them survive it? We know that personality affects both lifestyle and habits, which may lower or raise your cancer risk.

If you ignore warnings about smoking for example, or continue to engage in other risky health behaviors, you increase your risk of cancer. Another high-risk trait is procrastination in seeing a doctor when you have a symptom, like a persistent cough or bleeding. This is sometimes called the “ostrich” syndrome, which is trying to avoid a problem, or deny that it may exist out of fear.

One theory suggests that people with repressive personalities, who look calm but hold in a cauldron of painful emotions, are more prone to develop cancer. Dr. Lydia Temoshok, a psychologist who led a number of research studies on personality and cancer at the University of California, San Francisco, labeled this type C personality (by the way, the C doesn’t stand for cancer). You are likely to be familiar with the Type A (hostile, impatient) personality and the Type B (docile, passive) personality, which led to a greater or a lesser risk of heart attack. Type C individuals are in between. They have a dramatic physical response to stress, yet they report that they are not highly stressed at all.

Although Temoshok and her colleagues found some differences in cancer risk and survival among Type C patients with melanoma, the general consensus in the scientific community is that there is insufficient evidence to make the leap that if you are Type C, you are more prone to cancer or less likely to survive it than other people.

Another theory suggests that people with a “fighting spirit,” survived longer than those who were stoic or passive. We know today that the primary predictor of survival for women with breast cancer, is whether the cancer has spread to the lymph nodes under the arm. But at the time of their research, scientists did not know this, so in the earlier study, no one checked the lymph nodes to look for cancer spread. Consequently, this critical predictor was not taken into account in the Greer-Watson study. The bottom line? Current knowledge tells us that the strongest factor in survival from breast cancer is the presence or absence of positive nodes for cancer, not the personality of the individual. A “fighting spirit” is surely a helpful way to cope, but we don’t know that it directly influences biological survival.

Over the years, many studies have been conducted to clarify the role of personality in health. The studies have frequently found contradictory or inconclusive results. This is largely because of the difficulty in carefully studying both psychological and physical domains at the same time. It is natural therefore, for people to throw up their hands and say, “They really don’t know what they’re doing,” or “How can they get such conflicting results? They can’t all be right!” Scientists tolerate these differences, recognizing that it takes many studies to gather sufficient information to prove any given fact with certainty.

In conducting research, there is always the question. Did they control all the factors so that no “red herring” could account for the results? This is the only way researchers can be sure that the results are accurate. The best studies today try to avoid these glitches by carefully considering and “controlling” all relevant factors.

Rather than trying to pin cancer risk on certain personality types, research in recent years has explored the role of individual’s coping patterns. How people handle the daily hassles in their life, correlates to how they deal with cancer and its outcome. Certainly, if your personality leads you to go to a doctor quickly with a symptom that might be cancer, you likely get an earlier diagnosis, which will more probably lead to cure. If you procrastinate, cancer may be diagnosed later, at a less curable stage. Other personality traits, such as tenacity and persistence, play a role in determining whether you doggedly hang in to complete the treatment.

The myth of the cancer personality is akin to the tyranny of positive thinking. Jesse, a fifty-one-year-old college professor with Hodgkin’s disease, summed up the controversy this way:

What difference does it make telling me my personality might have given me cancer? It’s like telling me my blue eyes caused cancer. Even if it were true, I can’t change it. Tell me something I can do something about.

Jesse’s right. You can’t change the enduring parts of your personality. However, you can use your ways of coping to advantage by maintaining a healthy lifestyle, seeking care if you have a symptom suggestive of cancer or one that is unexplained for weeks, and hanging in with the treatments if it is cancer.

Did stress alter my immune system and cause me to have cancer?

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Many researchers studies have shown that stressful life events, from the death of a loved one to the loss of a job, are linked to an increase in certain health problems, particularly heart disease, diabetes, and hypertension. Many people assume that stress leads to cancer as well. Evidence for this, however, is not clear.

For the time being, there is no proof that the hormonal and mild immune system blips caused by stress influence the onset or progression of cancer.

What we know about stress is that when we are confronted with a f