Married patients with locally advanced lung cancer likely to survive longer after treatment

University of Maryland Medical CenterSep 7 2012

Married patients with locally advanced lung cancer are likely to survive longer after treatment than patients who are single, according to a study by researchers at the University of Maryland Marlene and Stewart Greenebaum Cancer Center in Baltimore. The results of the retrospective study are being presented at the 2012 Chicago Multidisciplinary Symposium in Thoracic Oncology.

The University of Maryland researchers studied 168 patients with Stage III non-small cell lung cancer, the most common type of lung cancer, who were treated with chemotherapy and radiation over a 10-year-period, from January 2000 and December 2010. They found that 33 percent of married patients were still alive after three years compared to 10 percent of the single patients, with women faring better than men. Married women had the best three-year survival rate (46 percent), and single men had the worst rate (3 percent). Single women and married men had the same 25 survival rate at three years. White married patients had a better survival rate than married African-Americans.

"Marital status appears to be an important independent predictor of survival in patients with locally advanced non-small cell lung cancer," says the study's lead author, Elizabeth Nichols, M.D., a radiation oncology resident at the University of Maryland Greenebaum Cancer Center. "The reason for this is unclear, but our findings suggest the importance of social support in managing and treating our lung cancer patients. Patients may need help with day-to-day activities, getting to treatment and making sure they receive proper follow-up care."

"We believe that better supportive care and support mechanisms for cancer patients can have a greater impact on increasing survival than many new cancer therapy techniques. Not only do we need to continue to focus on finding new drugs and cancer therapies, but also on ways to better support our cancer patients," says Dr. Nichols, who collaborated on the study with senior faculty at the University of Maryland School of Medicine.

The study's senior author, Steven J. Feigenberg, M.D., an associate professor of radiation oncology at the School of Medicine, says additional research is planned. "We need to better understand why marriage is a factor in our patients' survival," says Dr. Feigenberg, who is also a radiation oncologist at the University of Maryland Greenebaum Cancer Center. "We're also trying to determine if these findings can be corroborated in the multi-institutional setting,"

E. Albert Reece, M.D., Ph.D., M.B.A., vice president for medical affairs at the University of Maryland and the John Z. and Akiko K. Bowers Distinguished Professor and dean of the University of Maryland School of Medicine, says, "Lung cancer is the No. 1 cause of cancer death in both men and women, and this study by researchers at the University of Maryland School of Medicine suggests that having a spouse who can act as a caregiver may improve survival for patients with this type of cancer. We must figure out ways to help all of our cancer patients live longer, with a better quality of life, regardless of their marital status."

The patients in the study were evaluated by a multidisciplinary team of radiation oncologists, surgeons and medical oncologists at the Greenebaum Cancer Center and were treated with a standard combination of radiation and chemotherapy, typically followed by additional rounds of chemotherapy. With a mean follow-up of a year and four months, the mean survival was 13 months. Researchers used an analysis tool to estimate overall survival, with 21 percent of the patients alive at three years and 12 percent at five years.

Previous studies have found decreased survival for single men diagnosed with several types of cancer, including prostate and head-and-neck cancers. A study of 440,000 Norwegian men and women, published last year, found that men who never married were 35 percent more likely to die from cancer than married men. Never-married women were 22 percent more likely to die of cancer than those who were married. The study looked at deaths from 13 common cancers.