Marital distress may worsen breast cancer recovery

Women coping with difficulties in their marriage have a harder time recovering from treatment for breast cancer, researchers have found.

Breast cancer survivors involved in an ongoing but distressed marriage or long-term relationship "showed not only a slower recovery in overall physical functioning but also more side effects from treatments," Dr. Hae-Chung Yang told Reuters Health.

When women in distressed relationships also suffered from depression, which Yang noted was often the case, "she showed worsening physical symptoms and dietary habits."

Yang and co-investigator Tammy A. Schuler, both of Ohio State University in Columbus, assessed stress, health behaviors, and health outcomes every 4 to 6 months over 5 years among 100 breast cancer survivors.

Overall, 56 percent had undergone modified radical mastectomy, while 60 and 92 percent had adjuvant radiotherapy and chemotherapy, the investigators report in the journal Cancer.

The women were all in stable relationships, lasting about 22 years, but 28 of them reported their relationship as distressed. The remaining women said they had a non-distressed relationship.

At the outset, the distressed group showed significantly lower levels of physical activity, greater and more severe symptoms such as nausea, and more symptoms of depression.

Over 5 years, women in distressed relationships showed "slower recovery from cancer-related traumatic stress symptoms such as unwanted thoughts about cancer diagnosis/treatments and fear of recurrence," said Yang.

These women also had continuously heightened levels of stress, and the tendency for worsening exercise and poor eating habits.

Yang and Schuler suggest that screening breast cancer survivors for depression would help identify those involved in distressed relationships who could benefit from appropriate referrals for assistance.

"Such assistance," they say, "may offset poor survivorship outcomes for patients doubly burdened by psychological distress and relationship problems."

SOURCE: Cancer, January 2009