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Better coping strategies needed to reduce anxiety in partners of breast cancer survivors
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Many partners of young breast cancer survivors reported anxiety, which can worsen the quality of life of themselves and their partner, according to a prospective cohort study scheduled for presentation at the Cancer Survivorship Symposium.
Further, partners with maladaptive coping strategies reported negative mental health outcomes even after their partner’s treatment had ended.
“Breast cancer is one of the most common cancers in women and, as the number of breast cancer survivors grows, it is incumbent upon us to increase our understanding of concerns of partners and caregivers and how to best help them cope with cancer diagnosis and treatment,” Nancy Borstelmann, MD, MPH, director of social work at Dana-Farber Cancer Institute, said in a press conference.
Borstelmann and colleagues recruited partners of breast cancer survivors who were diagnosed when aged younger than 40 years to participate in a one-time survey detailing their concerns with their partner.
The aim of the study was to explore psychosocial concerns and mental health in the partner and exam psychosocial and demographic factors associated with anxiety. The researchers also looked at coping strategies partners used in response to stress, anxiety depression, parenting, relationship, social support and financial concerns.
A total of 250 partners (median age, 43 years; range, 27-65) responded to the online/mailed survey, most of whom were men (n = 284). Most of the partners were white (93%), working full time (94%) and college educated (78%).
The median time of survey completion was 62 months (range, 16-114) after their partner’s cancer diagnosis.
Overall, 42% of partners experienced anxiety even several years after cancer diagnosis and 32% had relationship concerns.
Univariable analyses showed lower education and maladaptive coping — which includes emotional withdrawal, denial, alcohol consumption, blaming others and becoming more agitated — were associated with anxiety (P < .05 for all).
That education appeared to play a role may be a proxy for other issues going on in someone’s life, Borstelmann said.
“For example, lower education level may be related to your level of income and ability to access other resources that could help you in supportive ways,” Borstelmann said. “Sometimes individuals with lower levels of education may feel a little more hesitant to speak up, possibly. In general, as health care systems, we do a good job of sharing information but sometimes we have to question whether we are doing a good enough job with health literacy and whether the information we are giving to our patients and families is understandable to them.”
Other stressors also were associated with increased anxiety, which included parenting — 75% of partners were parenting children aged younger than 18 years at cancer diagnosis — financial concerns and lack of social support (P < .05 for all).
“One of the first things we need to do is start asking the partners how they are doing to bring them into the conversation,” Borstelmann said. “The best work we can do is to intervene earlier and identify some of their needs and concerns and be sure they have adequate information.”
On multivariable analysis, partners who used less effective or maladaptive strategies were more than twice as likely to report higher levels of anxiety (OR = 2.32; 95% CI, 1.22-4.39).
Physicians can refer partners to certain groups to give them more options for extra support.
“Support groups, meeting with a social worker and giving them access to talking with other partners who may have been through this may help partners feel less alone,” Borstelmann said, adding that early intervention can also help prepare parents for questions asked by their children. “We want you to be able to talk to your children,” she said.
It is important for the partner of a patient with cancer to remember to take care of themselves, Merry Jennifer Markham, MD, associate professor in the division of hematology and oncology at University of Florida Health, and an ASCO expert, said during the press conference.
“We know that caring for someone with cancer comes with a unique set of concerns and worries — this study highlights this,” she said. “When partners of [patients with cancer] take care of themselves, it really does benefit everyone.” – by Melinda Stevens
Reference:
Borstelmann N, et al. Abstract 184. Scheduled for presentation at: Cancer Survivorship Symposium; Jan. 27-28, 2017; San Diego.
Disclosures: Borstelmann reports no relevant financial disclosures. Please see the abstract for a list of all other researchers’ relevant financial disclosures.