Married esophageal cancer patients fare worse in some quality of life aspects than single patients

Sep 27 2007

In a surprising finding, American scientists have found that when battling oesophageal cancer, married patients don't fare as well as their single counterparts in certain aspects of their quality of life.

In the study, presented at the European Cancer Conference (ECCO 14) in Barcelona, 212 oesophageal cancer patients and 489 patients with Barrett's oesophagus, a non-cancerous condition linked to acid reflux, filled out two quality of life questionnaires a year apart. Changes in the scores between the two assessments were analysed according to marital status.

No differences in quality of life changes over time were seen between marital states in the patients with Barrett's oesophagus. That finding was expected because the condition is not a potentially fatal one requiring stressful major treatment.

“In general, there were not major differences in quality of life between single and married oesophageal cancer patients, but there were slight differences in some aspects,” said the study's lead researcher, Dr. Robert Miller, an assistant professor of oncology at the Mayo Clinic in Rochester, Minnesota.

For the single patients, quality of life scores relating to pain frequency, overall physical wellbeing and legal worries improved between the first and second questionnaire. However, married patients reported less improvement in their legal worries than the single patients did, and worsening physical wellbeing and increasing pain frequency over time.

“In the second questionnaire, single people rated their overall physical quality of life at a score 0.7 points higher on a scale of one to 10 than they did on the first questionnaire. However, for married people, the score dropped 0.4 points,” Miller said.

The results for pain frequency were similar, with the singles improving by 0.6 points and the married patients reporting a 0.9-point deterioration.

When it came to perceptions of legal worries, all patients reported improvement, but the singles moved 1.1 points up the scale, while the married patients gained only 0.2 points.

“These findings were surprising, as we thought we'd be demonstrating improved outcomes in married patients,” Miller said.

Most previous studies comparing the quality of life of married and single cancer patients, chiefly in breast but also in brain cancer, indicate that married people do better than single people, noted Miller. He said one reason why the current study came out differently could be that oesophageal cancer has a worse prognosis in comparison to some of the other types of cancers previously studied.

Also, there were approximately nine men to every woman in the oesophageal cancer group. This gender ratio may account for the difference between the latest results and those seen in studies of breast cancer patients.

“It's hard to interpret why married patients didn't do as well as single patients, but one explanation could be that having a family to support and care for when you have a serious and potentially life-threatening disease may increase a person's worries, leading to a decrease in quality of life,” said Miller. “Being single may be associated with less negative changes in quality of life over time because the disease is more disruptive if you have others relying on one's participation in family social and economic activities.”

Married patients diagnosed with oesophageal cancer may require extra diligence when evaluating pain and other somatic complaints, and there may be issues outside the standard concerns of medicine, Miller said.

http://www.ecco-org.eu/