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The authors evaluated recurrence and survival for 68 patients with malignant melanoma who participated in a 6-week structured psychiatric group intervention 5 to 6 years earlier, shortly after their diagnosis and initial surgical treatment. The investigators explored the role of several factors as possible predictors of outcome, using a randomized controlled experimental study design. For control patients, there was a trend for recurrence (13/34) and a statistically significant greater rate of death (10/34) than for experimental patients (7/34 and 3/34, respectively). The authors found that participation in the group intervention predicted enhanced survival and this finding could not be explained away by implicating other related factors (such as lesion depth). Finally, baseline affective distress and baseline coping were significant psychological predictors for recurrence and survival. Surprisingly, higher levels of baseline distress as well as baseline coping and enhancement of active behavioral coping over time were predictive of lower rates of recurrence and death. The authors concluded that psychiatric interventions that enhance effective coping and reduce affective distress appear to have beneficial effects on survival but are not proposed as an alternative or independent treatment for cancer or any other illness or disease. This is the second randomized clinical trial in the past 3 years to show a prolongation of life among patients whose standard treatment for cancer is supplemented with a psychosocial intervention designed to provide social support and enhance coping effectiveness.