Social Influences on Clinical Outcomes of Patients With Ovarian Cancer

Abstract

A B S T R A C T PurposePrevious research has demonstrated relationships of social support with disease-related biomarkers in patients with ovarian cancer. However, the clinical relevance of these findings to patient outcomes has not been established. This prospective study examined how social support relates to long-term survival among consecutive patients with ovarian cancer. We focused on two types of social support: social attachment, a type of emotional social support reflecting connections with others, and instrumental social support reflecting the availability of tangible assistance. Patients and MethodsPatients were prospectively recruited during a presurgical clinic visit and completed surveys before surgery. One hundred sixty-eight patients with histologically confirmed epithelial ovarian cancer were observed from the date of surgery until death or December 2010. Clinical information was obtained from medical records. ResultsIn a Cox regression model, adjusting for disease stage, grade, histology, residual disease, and age, greater social attachment was associated with a lower likelihood of death (hazard ratio [HR], 0.87; 95% CI, 0.77 to 0.98; P ϭ .018). The median survival time for patients with low social attachment categorized on a median split of 15 was 3.35 years (95% CI, 2.56 to 4.15 years). In contrast, by study completion, 59% of patients with high social attachment were still alive after 4.70 years. No significant association was found between instrumental social support and survival, even after adjustment for covariates. ConclusionSocial attachment is associated with a survival advantage for patients with ovarian cancer. Clinical implications include the importance of screening for deficits in the social environment and consideration of support activities during adjuvant treatment.

Helplessness/hopelessness, minimization and optimism predict survival in women with invasive ovarian cancer: a role for targeted support during initial treatment decision-making?

“…While there is some evidence to support a relationship between negative emotional responses, unfavorable coping styles, optimism, depression and social support with cancer recurrence and survival [7,[15][16][17][18][19][20][21], results are inconsistent. Interpreting many of these studies is difficult as they fail to effectively control for prognostic factors and do not adequately consider potential interactions between psychosocial and disease or treatment variables over time.…”

“…found that perceived social support was correlated with disease related biomarkers, including NK cell activity [26] and interleukin-6 [27] in women with ovarian cancer. This group have directly linked social support and survival in ovarian cancer, specifying a particular aspect of social support, lower social attachment pre-surgery, predicting shorter survival in 168 women controlling for disease characteristics [21]. Depression and practical social support were not related to survival, while other coping factors were not considered.…”

Online Social Networks - Opportunities for Empowering Cancer Patients

“…Studies show that providing different supportive activities through social networks may be able to increase survival rate and decrease mortality, disabilities and recurrence in cancer patients (Vogt et al, 1992;Kroenke et al, 2006;Lutgendorf et al, 2012).…”

The Social Ecology of Adolescents’ Cancer Experience: A Narrative Review and Future Directions

“…Among individuals with a variety of chronic diseases (e.g., cancer, diabetes, coronary heart disease), social relationships, interpersonal interactions, and social support have been identified as some of the most important predictors of patients' health behaviors (Schiøtz et al 2012), mental health (Mehnert et al 2010), quality of life (Kim et al 2012), disease progression (Barth et al 2010), and survival time (Lutgendorf et al 2012). These findings suggest that interpersonal relationships can influence health outcomes by mitigating or exacerbating the negative effects of stress.…”