Marriage, Partnership Impacts Adherence to Cancer Treatment Guidelines

It is generally thought that a patient’s marital status and support system can affect disease outcomes, but the underlying link is not well-understood.

Patients who have a spouse or a partner may be more likely to achieve better outcomes for cancer by adhering to treatment guidelines, according to a study presented at the National Comprehensive Cancer Network (NCCN) 22^nd Annual Conference.

In the study, the authors examined outcomes for nearly 400 married and unmarried patients with stage 3 colon cancer.

The treatments that patients received were compared with the NCCN treatment guidelines for colon cancer. For stage 3 disease, the guidelines suggest patients receive surgery followed by 6 months of chemotherapy.

Overall, 85% of patients were administered chemotherapy; however, the authors discovered that partnered patients were more likely to finish 6 months of chemotherapy, which may have also increased their survival, according to the study.

“We found that patients who had a partner were almost twice as likely to complete the full 6 months of chemotherapy,” said lead researcher Christine M. Veenstra, MD, MSHP. “This finding is important as it points to a possible mechanism for improved outcomes that we had not recognized earlier.”

The authors noted that the state of the partnership was not observed to influence disease or response to therapy, according to the study.

The most common reason for treatment discontinuation was neuropathy.

“Partners may help patients manage and cope with the physical side effects of treatment, as well as provide important encouragement and positive support that unpartnered patients do not necessarily have,” Dr Veenstra said.

These findings suggest having a support system that includes a spouse or partner may be crucial for patients with cancer. The authors said these results can be used to identify ways to improve adherence to treatment guidelines.

Additionally, clinicians should be trained to understand the risks facing unpartnered patients and how they may be connected to other support networks, including extended family, friends, support groups, and patient advocacy organizations, according to the study.

“The unpartnered patient population is at risk of not completing or receiving recommended care. We must work to ensure that support systems are in place so that patients are able to stay the course of treatment,” Dr Veenstra said.

The authors plan to conduct further studies to fully understand how marriage may improve adherence to guidelines and outcomes, including interviewing patients and their partners.

“I am interviewing patients and their partners about the role that the partners play and its impact on the patient -- I want to be able to look at this from the couple’s perspective—in their own words,” Dr Veenstra said.