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Date of release: 12 October, 2009

Marital status and cancer survival


Using the Surveillance, Epidemiology and End Results (SEER) database, a population-based cancer registry covering 26% of the US population, Sprehn and colleagues were able to compare survival rates with marital status at the time of diagnosis in cancer patients [1]. A total of 3.9 million people were included in the analysis of all-site cancers. Survival was highest among married patients: 63% at 5 years and 57% at 10 years after diagnosis. Those separated from their spouses had the lowest survival (45% and 37%, respectively), followed by those who were widowed (47%, 41%), divorced (52%, 46%) and never married (57%, 52%). The 5-year and 10-year relative survivals of separated patients were 72% and 64% than that of married patients. The relationship persisted when data were analyzed by gender. There were no sub-analyses by the type of malignancy.

Comment

This study gives another opportunity to witness that the human body and soul are tied together and that emotional and psychological factors may have a substantial impact on various diseases, including cancer. Married patients do better since they have support from a partner and their economic status is usually better than that of unmarried patients. The most vulnerable people seem to be those recently separated. They are more likely to be stressed since they are in the midst of a painful transitional period, characterized by loneliness, uncertainty and a need to adapt to a new status in life. Contrarily, never-married people were doing relatively well, since they were used to living alone. Social support and marital status have been shown to correlate with immune function [2], and stress has been demonstrated to increase pro-inflammatory reactions [3]. The progression of a tumor is determined by many factors which include hormones, cytokines and various mediators. The psychosocial environment for each patient may affect the immune/inflammatory cascades and therefore may have an important role in prognosis [4].

Comentario

Amos Pines
Department of Medicine T, Ichilov Hospital, Tel-Aviv, Israel

    References

  1. Sprehn GC, Chambers JE, Saykin AJ, Konski A, Johnstone PA. Decreased cancer survival in individuals separated at time of diagnosis: critical period for cancer pathophysiology? Cancer 2009 August 24. Epub ahead of print.
    http://www.ncbi.nlm.nih.gov/pubmed/19705348

  2. Steptoe A, Owen N, Kunz-Ebrecht SR, Brydon L. Loneliness and neuroendocrine, cardiovascular, and inflammatory stress responses in middle-aged men and women. Psychoneuroendocrinology. 2004;29:593-611.
    http://www.ncbi.nlm.nih.gov/pubmed/15041083

  3. Bauer ME, Jeckel CM, Luz C. The role of stress factors during aging of the immune system. Ann NY Acad Sci 2009;1153:139-52.
    http://www.ncbi.nlm.nih.gov/pubmed/19236337

  4. Gidron Y, Ronson A. Psychosocial factors, biological mediators, and cancer prognosis: a new look at an old story. Curr Opin Oncol 2008;20:386-92.
    http://www.ncbi.nlm.nih.gov/pubmed/18525332