Breast cancer patients who have a strong social support system in the first year after diagnosis are less likely to die or have a recurrence of cancer, according to new research from Vanderbilt-Ingram Cancer Center (VICC) and the Shanghai Institute of Preventive Medicine. The study, led by first author Meira Epplein, PhD, assistant professor of Medicine at VICC, was published in the Journal of Clinical Oncology.
Patients in the study were enrolled in the Shanghai Breast Cancer Survivor Study, a large, population-based review of female breast cancer survivors in China, which Vanderbilt University Medical Center and the Shanghai Institute of Preventive Medicine have carried out since 2002 under the leadership of principal investigator Xiao Ou Shu, MD, PhD, professor of Medicine at VICC, and senior author of the study.
From 2002 to 2004, a total of 2,230 breast cancer survivors completed a quality of life survey 6 months after diagnosis and a majority responded to a follow-up survey 36 months after diagnosis. The women were asked about physical issues such as sleep, eating and pain, psychological well-being, social support and material well-being. The answers were converted to an overall quality of life score.
During a median follow-up of 4.8 years after the initial quality of life assessment, the investigators documented participants who had died or been diagnosed with a cancer recurrence.
Six months after diagnosis, only greater social well-being was significantly associated with a decreased risk of dying or having a cancer recurrence. Compared to women with the lowest scores, women who scored highest on the social well-being quality of life scale had a 48% reduction in their risk of a cancer recurrence and a 38% reduction in the risk of death.
Emotional support was the strongest predictor of cancer recurrence. Specifically, women reporting the highest satisfaction with marriage and family had a 43% risk reduction, while those with strong social support had a 40% risk reduction and those with favorable interpersonal relationships had a 35% risk reduction.
“We found that social well-being in the first year after cancer diagnosis is an important prognostic factor for breast cancer recurrence or death,” Epplein stated in a press release. “This suggests that the opportunity exists for the design of treatment interventions to maintain or enhance social support soon after diagnosis to improve disease outcomes.”
While a strong social support network influenced cancer recurrence and mortality during the first year, the association tapered off and was no longer statistically significant by the third year after diagnosis. This may be related to a smaller sample size of patients who answered the questionnaire, or other factors beyond quality of life that take precedence in later years.
“Our research supports previous studies that found a benefit for breast cancer patients who have a meaningful emotional support network,” Epplein stated. “These results suggest that therapeutic interventions may be useful because social well-being is potentially modifiable.”