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The study involved more than 1,000 men and women older than 18 with cancers of the mouth, tongue and throat that had not spread. A questionnaire assessed quality of life, including physical health, family and social connections and emotional status. The patients were followed for an average of nine years, until death or until they stopped participating.

Although age, tumour classification, cigarette smoking and other variables were predictors of survival, scores on emotional well-being tests had no predictive value.

"A fighting spirit has its advantages, but one of them is not, apparently, cancer survival," said James C. Coyne, lead author of the study, which appeared online Oct. 22 in the journal Cancer. "We looked at whether exceptionally high emotional well-being or exceptionally low emotional well-being had an effect. We found absolutely no evidence for either." Coyne is a professor of psychology at the University of Pennsylvania.

The authors acknowledge that participants had to be judged mentally fit to consent, follow instructions and keep appointments, which may make the sample somewhat unrepresentative.  But its large size — there were 646 deaths in the group, which is larger than the entire sample— gives the work considerable strength.