Cancer patients who are separated from their spouses at the time of their diagnosis do not live as long as widowed, divorced and never married patients, according to a new study to be published in CA, the journal of the American Cancer Society.
Andre Konski, M.D., M.B.A., M.A., professor and chairman of the Department of Radiation Oncology at the Wayne State University School of Medicine, took part in the study and co-wrote the article with a group of researchers led by Gwen Sprehn, Ph.D., of the Indiana University School of Medicine Department of Neurology. Konski is chief of radiation therapy at the Barbara A. Karmanos Cancer Center, Research has shown that personal relationships play a significant role in physical health, Konski said. Many studies focusing on cancer prognosis have found that patients who are married live longer than those who are single.
"This study should help us understand the role of how important social support is for the cancer patient and how it impacts outcome of cancer therapy," Konski said.
To look for trends in cancer survival among patients who are separated, divorced, widowed and never married, the researchers analyzed data from the Surveillance Epidemiology and End Results database, a population-based cancer registry in the United States. The researchers assessed the five- and 10-year survival rates of 3.79 million patients diagnosed with cancer between 1973 and 2004. They found that married patients had the highest five-year and 10-year survival rates, at 63.3 percent and 57.5 percent respectively. Separation carried the poorest survival rates, at 45.4 percent and 36.8 percent respectively. The five-year and 10-year survival rates of widowed patients were the next lowest, at 47.2 percent and 40.9 percent respectively; for divorced patients, the respective survival rates were 52.4 percent and 45.6 percent; and for never married patients, they were 57.3 percent and 51.7 percent.
The researchers, Konski said, believe the stress of separation may compromise the immune system and thus create greater vulnerability to cancer. "The reason is unclear, but I have written a couple of papers showing that unpartnered male patients do worse in head and neck cancer and metastatic prostate cancer," he said. "The reason is unclear, and could be related to reduced support while going through treatment."
While additional research is needed, the researchers said, certain interventions might help. Those include psychological interventions to reduce stress that may impact the immune system.
"Patients who are going through separation at the time of diagnosis may be a particularly vulnerable population for whom intervention could be prioritized," Sprehn said. "Identification of relationship-related stress at time of diagnosis could lead to early interventions that might favorably impact survival. Ideally, future research will study marital status in more detail over time and also address individual differences in genetic profile and biomarkers related to stress, immune and cancer pathways in order to determine mechanisms which might underlie this possible critical period for cancer pathogenesis."
Other researchers who developed the article, "Decreased cancer survival in individuals separated at time of diagnosis: critical period for cancer pathophysiology?" include Indiana University School of Medicine faculty members Joanna E. Chambers, M.D., of the Department of Psychiatry; Andrew J. Saykin, PsyD., of the Department of Radiology; and Peter A. S. Johnstone, M.D., of the Department of Radiation Oncology.