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In sickness and in health: how marriage helps cancer patients

Actor Tom Hanks’ wife Rita Wilson says she’s been “blown away” by her husband’s support throughout her current battle with breast cancer. EPA/FACUNDO ARRIZABALAGA

A growing body of research evidence shows being married greatly increases patients’ chances of being cured of cancer. But while there’s a clear link between marriage status and treatment outcome, the benefit is likely to extend to anyone in a close personal relationship.

The most recent such work is from doctors and scientists at Harvard University who published their findings in the peer-reviewed journal Cancer. It shows people who are married are less likely to die from head and neck cancer.

These findings are consistent with other research that has found links between marriage and treatment success in a range of cancer types including prostate, uterine and breast and pancreatic.

What’s the evidence?

The Harvard study collected data from over 51,000 patients who were diagnosed with a form of head or neck cancer between 2007 and 2010, via the National Cancer Institute’s epidemiology program, SEERS.

While the main focus of the research was marital status, it also looked at other factors such as tumour site, race, income, insurance status, age and sex. The study authors found married people were 28% to 47% less likely to present with cancer that had spread to other areas in the body, which is a key determinant in treatment success.

The importance of having a spouse appears to come from their ability to detect the early signs of cancer. This may include visual changes in their partner but also audio clues like hoarseness when speaking, difficulty swallowing or other changes in their voice. After picking up these signs, spouses tend to encourage their partner to visit a doctor, which leads to earlier diagnosis and treatment.

The study authors suggest the continuing support provided by spouses also plays a key role in their partners’ treatment success. Married patients were more likely to listen to their doctors’ advice and adhere to their medication schedules.

A similar effect probably holds for anyone diagnosed with cancer who lives in a committed relationship, whether same-sex, de facto or who lives with an extended, but close, family unit. Elliot Margolies/Flickr, CC BY-NC-ND

While the study examines the importance of spousal influence, it doesn’t elaborate on the importance of other factors such as whether the patients were regular smokers, consumed high levels of alcohol or were at risk of cancer from other causes, such as human papilloma virus (HPV).

It also didn’t analyse the role of other health professionals in the early detection of neck and head cancer. People who have regular medical and dental check-ups can also be expected to have their cancers found earlier, and so have a higher rate of treatment success.

Although the Harvard researchers identify limitations in their work, several other studies have demonstrated a similar link between marriage status and cancer treatment outcome.

A study of prostate cancer patients showed married men survived significantly longer after diagnosis and had a lower risk of dying from their cancer than those who were divorced, single, separated or widowed. Another study that also used the SEERS program found a survival advantage for married women with uterine cancer, compared to unmarried and widowed women.

Learning from research

As noted above, while all the studies described here looked at people who were formally married, it’s likely the treatment outcomes would be similar for anyone diagnosed with cancer who lives in a committed relationship, whether same-sex, de facto or who lives with an extended, but close, family unit.

But what about the people who don’t have a significant other with whom they live? Research points to the importance of good surveillance and follow-up of single people, particularly those in high-risk groups such as smokers or heavy drinkers. Routine visits to doctors and dentists may be an extremely effective stand-in.

The Harvard study also highlights the need for targeted social support that can be integrated into the care of cancer patients for the duration of their treatment. Initiatives can and should include regular home visits or calls from health workers, communal accommodation so single people can live together, or cancer patient support groups.

Almost 128,000 new cases of cancer will be diagnosed this year in Australia alone. That number is likely to increase to 150,000 by 2020. Early diagnosis and effective treatment will always be a key element in curing this disease – no matter who facilitates it.

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