Holocaust survivors have more emotional problems coping with cancer than do patients without life-threatening experiences, a researcher said Saturday.

The research, conducted by doctors at Hadassah University Hospital in Jerusalem, was reported at the annual meeting of the American Association for Cancer Research."We were surprised to discover the unique way Holocaust survivors react to their cancer," said Dr. Tamar Peretz, oncologist and radiologist at the Hadassah University Hospital and study director.

"It seems the cancer triggers and amplifies the patient's repressed memories of the Holocaust. So, they're not only coping with the trauma of cancer, but also with an onslaught of highly disturbing emotions from the past."

Doctors need to realize Holocaust survivors and people with similar life-threatening experiences are high-risk cancer patients who may need additional guidance and emotional support through their treatment, she said.

The study began in 1986 and measured psychological distress and ability to cope with illness in a group of Holocaust survivors with cancer in remission. Their scores were compared with those from a control group of non-Holocaust cancer patients and a third group of healthy Holocaust survivors.

The Holocaust survivors with cancer had statistically higher levels of emotional distress than the other groups, but their ability to adapt to their illness was not diminished.

"Amazingly, we found the study group of Holocaust cancer patients could function well. They continue with work, visits to the clinic and daily activities," she said.

"But they suffer much more than non-Holocaust cancer patients. Everything they do requires a major effort. They're more severely depressed and have more trouble maintaining intimate relationships," Peretz said.

The diminished coping ability puts this subgroup of patients at high risk for stress-related problems, she said, adding they may have considerable difficulty handling chemotherapy or dealing with a relapse of the disease.

Researchers suggested Holocaust cancer patients' internal distress could have negative medical effects.

"The connection between emotional distress and the outcome of disease is still an open question," Peretz said. "But research suggests that psychological well-being increases the activity of lymphocytes responsible for fighting cancer cells." Lymphocytes are a type of white blood cell.

Hadassah University Hospital doctors are looking for new ways to help Holocaust cancer patients reduce internal distress.

"Research shows that Holocaust survivors don't respond to traditional psychotherapy. So, we're trying behavioral therapies such as relaxation and guided imagery."