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Marital Separation May Hurt Cancer Survival
Date:8/24/2009

Married and never-married did the best a decade later, study shows

MONDAY, Aug. 24 (HealthDay News) -- When it comes to surviving cancer, separation from your spouse appears to be worse for your health than divorce or even widowhood, a new study suggests.

In contrast, being married -- or never married -- seems to improve your odds the most.

An analysis of the records of nearly 3.8 million cancer patients found that married people fared the best after being diagnosed with cancer, while separated spouses were about one-third less likely to survive for a decade.

The stress of a separation seems to be key, said study author Gwen Sprehn, a neuropsychologist at the Indiana University School of Medicine.

"There may be a critical period early in the course of cancer when increases in stress have a particularly adverse effect on the immune system's ability to clear or suppress cancer," she said.

Researchers have known that marriage, in general, is good for a person's health, perhaps because spouses provide physical and emotional support before and during illness.

The findings, which will appear online Aug. 24 in Cancer, will be published in the Nov. 1 print issue of the journal.

After researchers made statistical adjustments to account for possible errors, they found that 36.8 percent of separated people lived for 10 years after cancer diagnosis, compared to 57.5 percent of those who were married. Almost 41 percent of widowed people live for a decade, as did 45.6 percent of those who were divorced and 51.7 percent of those who were never married.

The number of those separated was very small compared to the other groups -- 51,857 compared to 2,184,055 who were married.

Why might separated people die earlier than the widowed?

"The difference may be that the death of a spouse is closer to a natural phase in life," Sprehn said. "Coupled with that, those who are widowed may have a stronger support system, both personally and culturally. Separation, even if it is 'for the better,' is not an expected life event and may be preceded by a period of great conflict."

Janice Kiecolt-Glaser, director of Ohio State University College of Medicine's Division of Health Psychology, said the study is well-done and jibes with her own research on how the most stressful break-ups affect the health of spouses.

"Many studies have now shown that stress and depression reliably enhance inflammation," which can make cancer worse, she said.

The study leaves plenty of questions, however, apparently because of the limitations of the statistics the researchers used, said Hui Liu, an assistant professor of sociology at Michigan State University.

The research didn't take into account the marital history of those surveyed or some other details. "Previous research suggests that remarriages provide less health benefit than first marriages," she said. Also, studies suggest that longer marriages may have more health benefits, she noted, and the bad effects of marriages that fall apart may diminish over time.

More information

The American Institute of Stress has more on the importance of emotional and social support.



SOURCES: Gwen Sprehn, Ph.D., neuropsychologist, Indiana University School of Medicine, Indianapolis; Janice Kiecolt-Glaser, Ph.D., director, division of health psychology, Ohio State University College of Medicine, Columbus; Hui Liu, Ph.D., assistant professor, sociology, Michigan State University, East Lansing; Aug. 24, 2009, Cancer, online


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