Cancer diagnosis may raise psychological, cardiovascular risks for spouses, relatives
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A cancer diagnosis may lead to higher risk for psychological or cardiovascular illnesses among a patient’s family members, according to retrospective study results.
Researchers used the Utah Population Database to identify 49,284 people diagnosed with genitourinary cancers between 1990 and 2015, as well as 77,938 of their first-degree relatives. The analysis also included a matched control group of 246,775 people without genitourinary cancers and 81,022 of their first-degree relatives.
Follow-up occurred at 1, 3, and 5 years.
Within 5 years of a person being diagnosed with genitourinary cancer, 7.1% of their spouses or first-degree relatives had been diagnosed with a psychological illness and 7.6% had been diagnosed with a cardiovascular illness.
After 1 year of a person’s genitourinary cancer diagnosis, spouses or first-degree relatives exhibited higher risks for psychological illness (HR = 1.1; 95% CI, 1-1.2) or cardiovascular disease (HR = 1.28; 95% CI, 1.17-1.41) than matched controls.
Parents of children with cancer faced the highest risks for psychological or cardiovascular illnesses, with a nearly fourfold increased risk at 1 year compared with relatives who had non-parental relationships.
“A simple take home from this study for oncologists would be just to have the awareness that patients’ families and caregivers may also be impacted by a cancer diagnosis,” Mouneeb M. Choudry, MD, urology resident at Mayo Clinic in Arizona, told Healio. “Even just having small resources in your office like support groups for families could be useful [for] helping these family members or spouses.”
Healio spoke with Choudry about the study and the need for the potential effects of cancer diagnoses on spouses and relatives to be further investigated.
Healio: Before this study, had this topic been investigated extensively?
Choudry: There have not been many studies that tested this idea of stress and the echoing effects of cancer on caregivers. None really looked at it the way we did in terms of using these large family networks. One of the limitations in the United States is that there aren’t many databases that have these large family networks.
Healio: Why did you conduct this study?
Choudry: Between my third and fourth year of medical school at The University of Utah, I was involved in a research fellowship program with my mentor, Brock O’Neil, MD, and we both had some ideas relating to this topic. I have seen caregiver stress impact my own family members. This question of whether there was a link or whether it was just anecdotal was always in the back of my mind. Dr. O’Neill also had seen examples of this as a resident. Fortunately, I happened to be in a place where they had a database from which you could create these massive family networks to examine the possible impact.
Healio: How did you conduct the study?
Choudry: We looked at the risk for psychological illness — depression or anxiety — and cardiovascular disease, meaning heart attack or malignant/severe hypertension, among first-degree relatives and spouses after their loved one or family member received a genitourinary cancer diagnosis. This encompassed kidney, renal, bladder, testicular or prostate cancers.
Healio: What is your reaction to the findings?
Choudry: The data showed a 10% increased risk for psychological illness and a 28% increased risk for developing cardiovascular disease at 1 year, but I think this study underestimates those risks. We only looked at genitourinary cancers, but many other malignancies — such as pancreatic, breast, lung or brain cancers — have very strong impacts, as well. I think there is some utility in going back and looking at some of those risks.
Healio: Why do you think parents of children diagnosed with cancer had the most elevated risks for psychological illness or cardiovascular disease?
Choudry: I can’t say definitively, but my guess is that if you’re seeing your child go through something like that — regardless of whether they’re younger than 18 or already an adult — it’s going to be stressful. When it comes to cancer treatment, a lot of families of patients feel that there’s nothing they can do — it’s just a waiting game. That feeling of not being able to directly impact their care can be stressful.
Healio: What are the potential implications of this research?
Choudry: I don’t think this study should dictate any changes. There are still a lot of unknowns. Being involved in multidisciplinary clinics at Mayo Clinic, there is something to be said for developing better multidisciplinary care, where patients can come to one clinic visit. If there is a way that a patient doesn’t have to go to the hospital or clinic four, five or six times, that might reduce stress on the patient and their family.
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For more information:
Mouneeb M. Choudry, MD, can be reached choudry.mouneeb@mayo.edu.
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