"My cancer (multiple myeloma) came about six months after my father died and my mother is chronically ill too. I think the stress of caring for two sick parents made me vulnerable to cancer. Is that possible?"

Thank you for the excellent question. You have focused on a crucial, complex, and difficult question. Does stress contribute to the onset of cancer? The simple, but unsatisfying, answer to that question is we do not yet know, and for any specific person, there is no sure way of knowing. Research in this area has not provided any answers. While some studies seem to suggest a possible connection between stress and cancer, many others show no such connection. Additionally, much of the research is flawed in one way or another.

Still, we can make some sense of the research related to the mind-body connection and the science of psychoneuroimmunology. No matter how we interpret the research, the contribution of stress, bereavement, depression, or personality to cancer development is quite small. Many other powerful factors lead to the development of cancer. Heredity, environment, diet, and lifestyle (tobacco, alcohol usage) all play an important role.

Obviously, there is no way to know whether or not you would have developed multiple myeloma if your father was still alive and your mother was not ill. It is a completely natural and understandable human trait to want to know the reason one developed a serious illness. Many people that are diagnosed with cancer can point to specific stressful events, like yours, that immediately precede the cancer. However, given that stress, illness and death are an unavoidable part of life for ourselves and our loved ones, many people have severe stresses and do not develop cancer. Conversely, cancer often develops without any severe stresses occurring in one's life. My point here is that I feel that people often will make a causal connection that is not necessarily there.

To me, more important than struggling to answer the unanswerable, is the effect your views of this situation have on your emotion well-being and the actions you take or don't take. Here I am speaking very practically and pragmatically. I urge you to explore the meaning of this illness in your life. Hopefully, it can be an impetus to reorder priorities, to focus on what is meaningful, and to live fully in each moment. While not clear cut and absolute, certainly mind and body are connected and exploring stress management, relaxation, yoga, qi gong or other techniques may be quite helpful for your sense of well-being.

That is all well and good, but I would be remiss if I did not mention the role of negative emotions as well. Anger and sadness, tears and feelings of emptiness are an inevitable part of dealing with cancer (additionally they are part of grief and bereavement, which you are also experiencing). On a daily basis, I explain to people with cancer that "thinking positively" is not always possible. Let yourself have your negative emotions. Find a comfortable way of expressing them; to bottle them up or deny their existence is unrealistic and unhealthy.

The mind-body connection is an intriguing subject. My basic position is somewhere in the middle. Modern medicine is learning that we cannot separate the person from the illness. Illness happens to people; people with wishes and fears, hope and dream. We cannot, however, oversubscribe to the mind-body connection. Cancer is a powerful biological illness and its development in a specific person at a specific time often must remain a mystery.