Do you never lose your temper? Can you keep a stuff upper lip at the saddest of movies? Well, here's something that might really upset you. A study in the Journal of Psychosomatic Research warns that suppressing emotions can contribute to premature death from all causes, including cancer.

There has long been a debate about whether stress is a cause of cancer. Researchers have also asked if emotional responses to cancer affect survival rates. This latest US study used a sample from a national survey that asked about of emotional suppression (defined by researchers as a tendency to inhibit the expression of emotion)that followed 729 people over 12 years.

Subjects were asked how strongly they agreed with statements such as: "When I'm angry I let people know." Researchers found that death rates were higher among those who did not express their anger – for cases of cancer they found an increase of 70%. However, at 34 the number of people with cancer was small and the researchers do warn against jumping to the conclusion that suppressing emotion is detrimental. But isn't it better to err on the side of caution and start emoting more?

The solution

There is no consensus among the many available studies of a link between stress, emotion, personality factors, depression and the risk of cancer. A review of the evidence in the Clinical Psychological Review found no association between major life events and incidences of cancer. There is less clarity on the effects of stress on survival rates of cancer patients.

A review by The National Cancer Institute in America says that people who can deal with stress are more likely to have a better quality of life if they get cancer, but there is no solid proof that they will live longer. The review does cite some evidence that people who feel helpless may have higher death rates. This may be linked to higher levels of stress hormones such as adrenaline and noradrenaline, which may help cancer cells grow. Cortisol levels also rise with stress and may promote tumour growth.

Feelings of hopelessness may stop people getting help or looking after themselves. If such feelings do reduce life expectancy, it would seem likely that social support would help, yet some studies show that it improves life expectancy and others that it does not. The last thing someone with cancer needs is an expectation to behave in a certain way because others believe it may improve their chances of survival. However some research shows that when people with cancer feel emotionally supported (through groups, counselling or education) they experience less general symptoms, depression and anxiety.