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Marriage benefits may extend to cancer survival

For people with cancer, being married may improve survival, a new study suggests.

In the study, married people with cancer were about 20 percent less likely to die over a three-year period compared to unmarried people with cancer, regardless of the stage of their cancer..

What's more, married people with cancer were 17 percent less likely have metastatic cancer (cancer that has spread beyond the original site) a finding that suggests their cancer is being caught at an earlier stage and they were more likely to receive appropriate treatment for the disease.

It could be that the reason married people live longer is because they have more social support they have someone to share the burden of their diagnosis, which may reduce depression and anxiety as well as someone to take them to their appointments and ensure they adhere to their treatments, the researchers said. [6 Scientific Tips for a Successful Marriage]

The findings are not an affirmation of the health benefits of marriage, but instead, suggest that providing increased social support to unmarried people with cancer could benefit their health, the researchers said.

"If you have a friend or a loved one or someone you care about with cancer, you can potentially make a big difference in their outcome by going with them to their doctors visit, and helping them understand their diagnosis," said study researcher Dr. Paul Nguyen, a radiation oncologist at the Dana-Farber Cancer Institute and Brigham and Women's Hospital in Boston.

However, research on whether social support improves outcomes for patients with cancer has been mixed. More studies are needed to understand what kinds of social support interventions such as group versus individual counseling are the most helpful, said study researcher Dr. Ayal Aizer, a radiation oncologist at Brigham and Women's.

Benefits of marriage

The researchers analyzed information from more than 734,800 people in the United States who were diagnosed with cancer between 2004 and 2008. The study participants had one of 10 cancers: lung, colorectal, breast, pancreatic, prostate, liver/bile duct, non-Hodgkin lymphoma, head and neck, ovarian and esophageal cancer.

After taking into account factors that could affect patient survival, such as age, household income and cancer stage, the researchers found that people who were married were between 12 and 33 percent less likely to die from cancer than those who were not married. The biggest survival benefit was seen for head and neck cancers, and non-Hodgkin lymphoma.

Interestingly, the benefit of marriage on cancer outcomes was greater for men than women. More research is needed to understand the reasons for this finding, but it could be that unmarried women receive greater social support from friends, relatives and the community than unmarried men, the researchers said. A 2011 study from Norway found that unmarried men with cancer were more likely to die than married men with cancer, and that the disparity between the two groups had increased over the years.

Comparable to chemotherapy?

For about half the cancers studied (prostate, breast, colorectal, esophageal, and head/neck cancers), the survival benefit linked with marriage was greater than that linked with chemotherapy in previous studies, a result that surprised even the researchers.

While no one would argue that chemotherapy is an important treatment that should be given when needed, the new findings suggest the strength of the potential benefits of social support, Aizer said.

And although social support therapies would come with a cost, "it could actually be that we end up saving money in the long run," Aizer said, because the cancer is caught earlier, in stages where it is more likely to be curable.

However, Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in NY, said that there may be other differences between married and unmarried people (besides social support) that could explain some of the study findings. For instance, the study did not take into account whether participants smoked, drank alcohol, or exercised regularly all factors that may affect cancer survival.

"There's a connection [between marriage and cancer survival], but the connection is not necessarily marriage itself, it's all the things that go with marriage," Bernik said. Unmarried people may be more likely to engage in unhealthy lifestyle behaviors, which could contribute to their increased risk of mortality.

Future studies are needed that follow people forward in time (instead of looking back, as the current study did) to understand why marriage is linked with better cancer outcomes, Bernik said.

It is published today (Sept. 23) in the Journal of Clinical Oncology.

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