Social support may have a significant impact on cancer detection, treatment, and survival, according to the results of a study published in the Journal of Clinical Oncology. The study showed that married patients are less likely to present with metastatic disease, more likely to adhere to treatment protocols, and less likely to die from their disease.
To study the relationship between marriage and cancer treatment and outcomes, researchers analyzed data from the Surveillance, Epidemiology, and End Results (SEER) database. The analysis included data for 734,889 patients diagnosed with lung, colorectal, breast, pancreatic, prostate, liver/intrahepatic bile duct, head/neck, ovarian, or esophageal cancer, or non-Hodgkin’s lymphoma. These are considered the 10 leading causes of cancer-related death in the United States.
After adjusting for known confounders such as demographics, cancer stage, and type of treatment, the analysis revealed that married patients were less likely to present with metastatic disease, more likely to receive definitive therapy, and less likely to die as a result of their cancer. The relationship between marriage and cancer remained significant even when each individual cancer was analyzed. The benefit was greater for males than females. In five of the cancers studied—breast, prostate, colorectal, esophageal, and head/neck—the survival benefit associated with marriage was greater than the published survival benefit of chemotherapy.
The reasons for the relationship between marriage and survival are unclear. The researchers speculated that spouses may provide a critical level of social support and may encourage their partners to seek treatment when symptoms present and adhere to treatment protocols. What’s more, married patients may be less susceptible to depression—and this is important because depressed patients are less likely to comply with treatment. The researchers did not find a difference between unmarried subgroups such as single, separated, divorced, or widowed.
The researchers concluded that unmarried patients are at a significantly higher risk of presenting with metastatic cancer, being undertreated, and dying from their cancer. They speculate that marriage might provide a form of social support that can have a significant impact on cancer detection, treatment, and survival.
Aizer AA, Chen MH, McCarthy EP, et al. Marital status and survival in patients with cancer. Journal of Clinical Oncology. Published early online September 23, 2013. doi: 10.1200/JCO.2013.49.6489
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