On the third Thursday of every month, a group of women gather at Advocate Good Shepherd Hospital in Barrington, Ill. They sip tea out of china cups, nibble on cookies and share some of their worst moments.
"I'm Elaine, and I'm just starting to deal with cancer," says a white-haired woman whose husband has come along for support at the session sponsored by the national organization Y-Me.
She asks about the side effects of the chemotherapy her doctor has prescribed. Nearly everyone at this table can offer an answer.
To her left, Carol, a perky woman with a broad smile, talks about her diagnosis of breast cancer -- a relatively rare form that did not show up on her mammogram.
"I'm stage four," she says." I'm living with breast cancer and don't think I'll ever be out of treatment."
Support groups like this one are at the core of modern breast cancer care, helping women cope with a life-changing diagnosis. But beyond offering information and psychological support, new research questions how much talking about the disease and focusing on a positive outlook help someone beat the disease.
Eighteen years ago, Dr. David Spiegel of Stanford University Medical Center conducted a groundbreaking study that found that women with metastatic breast cancer who shared their problems and listened to those of others thought more positively about their own chances of survival and lived an average of 18 months longer than those who didn't get group support.
That study virtually jump-started the support-group movement and helped generate talk of a mind-body connection for cancer treatment.
"I think there has evolved over this past decade the sense that you've got to think positive to beat cancer," said Jimmie Holland, a psychiatrist at Memorial Sloan Kettering Cancer Center.
Others had been unable to duplicate Spiegel's findings. But recently Spiegel repeated his original study -- this time with surprising results. He found group therapy and positive thinking appeared not to be significant factors in a patient's life span.
"The take-home message from this study is that certainly group therapy helps people live better," Spiegel said. "It does not provide significant evidence that it helps them live longer."
Reaction from those in the cancer care community include some who say these latest findings raise doubts about the mind-body connection -- the idea that a good result is only possible with a positive attitude.
And Holland said that attitude can be hard to come by for a patient dealing with cancer treatments.
"I've had one patient who tells me that if one more person tells me to be positive I'm going to punch them in the nose. 'I've had enough of this positive business. I don't feel good today. Enough already,'" Holland explained.
For Jan Kuba, who underwent chemotherapy, radiation and radical surgery, the idea that her attitude would affect the outcome presented unwelcome pressure.
"I think, "Oh, those few times that I felt a little bit down, they're the ones that are going to kill me," Kuba said.
"They really make it seem like if you're not positive, then you're failing. And that's just not true," she said. "You're going to go through the down times and there's no way you're not going to feel depressed. You've just got to struggle to get back up."