Some perks of marriage are expected (all those amazing wedding gifts!) Others are unexpected — like added resilience against cancer.
A pair of companion papers just published in the American Cancer Society's peer-reviewed journal, Cancer, explored the impact of a few factors on cancer survival rates. One paper looked at how marriage and differing economic factors affect outcomes, while the other examined the relationship between cancer survival, race/ethnicity and marriage.
"We were interested in studying the marriage effect specifically because of the wealth of studies showing better cancer survival among married than unmarried patients," says lead author of the economic study, Scarlett L. Gomez, Ph.D., in an email interview. "However, no prior studies have been able to show why we consistently see such a difference, whether it is in fact due to having greater social support or having greater economic resources, or a combination of the two."
To figure out the magic equation of marriage + X = cancer survival, the team pulled no small amount of data from the California Cancer Registry. Information about nearly 400,000 male and 400,000 female cancer patients from 2000 to 2009 was examined. Patients must have been diagnosed with one of the 10 cancer types most commonly associated with death for their gender (for men, that included prostate, liver and lung cancer; for women, that included uterine, ovarian, brain and breast cancer).
The study once again confirmed that married individuals are likely to enjoy better cancer-related outcomes than their never married/divorced/separated/widowed brothers and sisters. But was this because two incomes meant more household money and therefore more resources to pay for medical treatment, or was it something else?
The researchers were surprised to find that the financial factor was not the reason. "While married cancer patients did certainly have greater economic resources, including having health insurance and lived in a higher socioeconomic status neighborhood, these factors actually explained very little of the marriage benefit," says Gomez, a scientist with the Cancer Prevention Institute of California. "Because of that, it then seems that the major driving factor is not due to married folks having greater economic resources, but rather due to their having greater social support, and less social isolation."
Social support can be given in a number of ways, from emotional backup to tangible assistance (rides to the doctor, caregiving.) "Spousal or children support/encouragement can lead to better health behaviors, such as adherence to recommended health screening and treatment, and health-promoting behaviors, such as more exercise and better diet," Dr. Gomez explains, adding that such support can also help to reduce stress, potentially even inhibiting tumor progression.
The second study looked at the same data but through the lens of race and ethnicity. They found that the survival rate was higher for married people in all racial groups, but the greatest difference was for non-Hispanic white men (24 percent greater rate). For foreign-born Hispanics and Asian/Pacific Islander females, marriage only made a 6 percent difference in survival rates (the lowest difference). Why the disparity? The researchers haven't nailed down firm explanations, but think that lack of social support from a partner or loved ones, lack of English language proficiency and difficulties navigating the health care system might be reasons why being married made less of a difference to minorities with cancer.
"We are unable to determine which specific factors as we do not have these data in the cancer registry," explains María Elena Martínez, Ph.D., lead author of the racial study and a professor at the University of California, San Diego School of Medicine.
These findings come at a time when greater numbers of men and women are opting out of marriage. In 1960, one in 10 people age 25 or older had never been married. As of 2012, the stat had skyrocketed to one in five. From a cancer mortality perspective, this number is concerning, but all hope is not lost for the single ladies and gentlemen of the world: Rely on your friends and relatives instead.
"The take-home message is that having a strong support system can have meaningful impacts on the odds of survival after a cancer diagnosis," Dr. Gomez says. "Single patients should take advantage of their support networks, even if they do not necessarily have spouses or children to turn to during a cancer diagnosis; this is particularly important for male patients."