REVIEW ARTICLE What is the state of the evidence on the mind–cancer survival question, and where do we go from here? A point of view Joanne E. Stephen & Michelle Rahn & Marja Verhoef & Anne Leis Received: 7 June 2007 / Accepted: 7 June 2007 / Published online: 26 June 2007 # Springer-Verlag 2007 Abstract Goals of work There is long history of anecdote and surmise linking psychosocial factors to cancer incidence and survival. However, over the past three decades, an increasing number of rigorous studies have investigated the possibility of a mind–cancer survival connection. The objective of this paper is (1) to review the past 30 years of psycho-oncology research on the mind–cancer survival question, (2) to review the methodological debate and interpretations of the research findings, and (3) to consider future research directions. Main results Over the past three decades, a small number of studies have been published. Some observational and qua- siexperimental studies suggest the possibility that coping and psychological factors may influence disease outcomes, but clinical trials suggest that psychosocial interventions do not prolong survival. Methodological comment and interpretation about the significance of these trials vary. Some researchers view the mind–cancer survival question as resolved and negative, whereas others identify conceptual and methodo- logical challenges and view the possible impact of psychoso- cial factors on survival as simply unproven. We take the position that the question is unanswered. Conclusion Recommended future research directions in- clude: (1) more trials based on testable theories, targeted interventions, and greater specificity in the measurement model and (2) new research questions and more rigorous observational, prospective, and longitudinal studies, case studies, mixed methods, and innovative design approaches being developed by complementary and alternative medi- cine researchers. Further research is warranted on the mind–cancer survival question. Keywords Survival . Mind–cancer . Methodology . Psychosocial . Evidence Introduction Mind–body approaches have been the primary focus of psychological interventions, and much research effort since the 1960s has been spent on testing their efficacy. Mind– body medicine also encompasses one of four categories of complementary and alternative medicine (CAM) defined by the National Centre of Complementary and Alternative Medicine in the USA. Traditional healing systems ac- knowledge that the power of the mind is integral to the treatment of ill health and consider illness an opportunity Support Care Cancer (2007) 15:923–930 DOI 10.1007/s00520-007-0281-4 J. E. Stephen Faculty of Health Sciences, Simon Fraser University, East Academic Annex #1000, 8888 University Drive, Burnaby, BC V5A 1S6, Canada J. E. Stephen (*) : M. Rahn Patient and Family Counseling, British Columbia Cancer Agency, 13750 96th Ave., Surrey, BC V3V 1Z2, Canada e-mail: jstephen@bccancer.bc.ca M. Verhoef Department of Community Health Sciences, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada M. Rahn Counselling Psychology, Trinity Western University, 7600 Glover Road, Langley, BC V2Y 1Y1, Canada A. Leis Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada