Research Round Up: Large Study Finds Association between Marriage Status and Improved Cancer Outcomes

Posted online September 23, 2013 on www.jco.org.

An analysis of data collected in a large retrospective study showed that married patients tend to live longer after a cancer diagnosis than unmarried patients. Married patients are also more likely to have earlier-stage cancer at diagnosis and more likely to receive appropriate treatments, such as surgery and radiation therapy.  The findings also suggest that more effort should be invested in improving social support services for unmarried patients with cancer.

For patients who are married, spouses are the primary source of social support ─ they share the emotional burden of the illness, encourage the patient to seek evaluation of abnormal symptoms and pursue screening, accompany patients to doctor’s visits, ensure they follow through with recommended treatments and receive appropriate pain management and help them cope with the various mental and emotional stresses of a cancer diagnosis and care. Married people also tend to have less anxiety and depression, two factors that have been linked to decreased cancer survival.

In this study, researchers assessed national cancer registry data of more than 700,000 patients diagnosed between 2004 and 2008. They found that being married decreased the odds of having metastatic disease when first diagnosed with cancer by 17% and increased the odds of receiving appropriate therapy by 53%. At any given time, a patient who was married was 20% more likely to be alive, on average, than a patient who was not married, regardless of tumor stage at diagnosis.

These benefits of marriage were consistent among each of the ten leading causes of cancer-related death in the United States ─ lung, colorectal, breast, pancreatic, prostate, liver/bile duct, non-Hodgkin lymphoma, head and neck, ovarian, and esophageal cancer, and persisted when researchers accounted for differences in characteristics of married vs. unmarried patients (for example, household income, education, race, gender).

What This Means for Patients

These findings add to the growing body of literature that suggests that marriage and, more broadly, social support helps patients cope with and survive cancer. Patients who are married tend to have better social support networks in place. Patients who are not married, however,  are encouraged to reach out to family and friends, cancer and faith-based support groups, social workers, or their doctors, nurses and other healthcare professionals to obtain the social support that they need, including assistance with decision-making, coping strategies, supportive and palliative care, and management of depression and anxiety.