Abstract

Introduction/ Background: Cancer survival is influenced not only by biological and clinical factors but also by psychological processes. The present study synthesizes evidence on how psychological determinants - such as depression, stress, coping styles, resilience, social support and optimism - affect cancer survival. Methods: The presentmeta-analysis considered research articles published till date and was conducted using databases including PubMed, PsycINFO, Scopus, and Web of Science. Eligible studies included longitudinal, cohort, or randomized controlled trials examining associations between psychological variables and cancer survival outcomes. Results: Stress and psychological distress - particularly depression and anxiety exhibited a weak or no association with survival across cancer types, with plausible behavioural and biological mechanisms including treatment non-adherence, HPA (hypothalamicpituitary-adrenal) axis dysregulation, and immune suppression. Conversely, factors such as optimism, positive effect, adaptive coping strategies, and resilience were significantly positively associated with cancer survival. Social support was highly consistently associated with improved survival. Psychosocial interventions showed modest survival benefits, particularly for highly distressed patients. Conclusion: Psychological factors can significantly modulate cancer outcomes. The analysis revealed that psychological well-being, coping strategies, social support, and personality traits significantly impact survival outcomes. Integrating psychological screening and interventions into oncology care may improve not only quality of life but also survival. Future research should prioritize mechanistic studies and targeted interventions for vulnerable groups.

Keywords

cancer survival, depression, stress, coping, resilience, social support, psychosocial interventions, psychoneuroimmunology, behavioural oncology