The Single Life

Wedding ringsLife is challenging enough for anyone facing cancer, but studies have revealed that cancer patients who are unmarried sometimes have unique disadvantages. As a single woman I have to agree that my battle with ovarian cancer has been influenced by the fact that I don’t have a life partner. Fortunately, I have family members who have served as caregivers during my chemotherapy treatments and following surgery, but I admit that I envy the majority of women who are married or in a long-term relationship. If they must undergo a cancer journey they can rely on the day-to-day physical, emotional and financial support of their spouse. There were instances in the hospital when I felt a little forsaken as I watched other women receive visits from their husbands and children. I also remember cringing a bit whenever a staff member would assume I was married, often referring to me as Mrs. Chartier rather than using the appropriate Miss. or Ms. before my name.

A 2013 study, in the Journal of Clinical Oncology, confirmed that cancer patients with a supportive spouse tend to fare considerably better than those who are on their own. The protective effect of marriage, as shown in this study, is almost shocking. Researchers from major U.S. cancer centres analyzed the records of 734,889 patients diagnosed with one of the 10 most common and fatal forms of cancer, from 2004-08. (These included lung, colorectal, breast and non-Hodgkin lymphoma.) After controlling for variables like age, sex, race, household income and education, they found that single people were 17 per cent more likely to be diagnosed with metastatic cancer, which had spread to other parts of the body, and were 53 per cent less likely to get the best treatment. Paul Nguyen, the study’s senior author, also revealed that patients who were married tended to live 20 per cent longer than those who were single, divorced, or widowed. The team concluded that the benefits of a happy marriage are comparable to—or better than—chemotherapy.

uterine-cancer2One interpretation of the findings is that if you’re married you’ve got a live-in advocate to pressure you to get to appointments — both screenings for earlier diagnosis and to cancer-fighting therapies after the disease has been diagnosed. It’s suspected that social support from spouses is also what’s driving the striking improvement in survival. Spouses often accompany patients on their visits and make sure they understand the recommendations and complete all their treatments, but there’s more to cancer survival than office visits. There are many additional factors that are influenced by the kinds of social support one has. It’s possible that the social support marriage provides helps stave off depression and stress, both of which have well documented negative effects on health and the immune system. Ultimately, the study results don’t imply that marriage is the only way to reap the rewards of social connections — presumably any tight-knit social network can provide the same kinds of mental and physical health benefits.

While my personal cancer journey continues to be shaped by the fact that I’m single, there are many other variables that influence me physically and psychologically. Most importantly, lacking the support of a spouse doesn’t necessary mean that my prognosis for survival is worse. My advice to other single cancer patients is to tap into your support network — this network likely includes parents, siblings and friends. Support for cancer survivors also consists of non-profit organizations, volunteers and the community at large. For example, if simply getting to treatment is a difficult task for you the Canadian Cancer Society offers help. Their Volunteer Driver Program strives to provide access to safe and reliable transportation for people who are receiving active treatment at approved cancer treatment facilities. This is an invaluable service, especially if you’re also dealing with physical or financial challenges or if the treatment centre is far from home.

In a League of Your Own: Why Every Cancer Patient is Different

I recently received some grim news regarding a close acquaintance with advanced breast cancer. After achieving about one year of remission, her doctors have informed her that her cancer has metastasized to her lungs. Apparently her current prognosis is extremely poor and oncologists have indicated that her disease is expected to progress to the terminal stage. I have to acknowledge that I have a certain degree of difficulty coping with circumstances such as this. Psychologically I accumulate unnecessary anxiety as I compare myself to other cancer patients. When I hear of bad outcomes, I keep asking myself if I’ll be next.

One of the psychological aspects of having ovarian cancer is fear of recurrence. Although I’ve been in remission for about two years now, I remain alarmed that when my cancer was diagnosed it was fairly advanced. The statistics reveal that recurrence rates are notoriously high for my type and stage of cancer. Throughout my personal cancer journey I’ve noticed that this fear of recurrence is heightened by another phenomenon, the tendency to compare my cancer to other people’s experience with the disease. For example, I’ll sometimes remind myself that if my disease follows the path that it does with most women I’ll encounter at least one recurrence within five years of my initial diagnosis.

Cancer Cells

There are few analogies that can accurately convey such feelings of dread to those who haven’t experienced them. Some cancer survivors have compared living with the disease to crossing a battlefield and watching your comrades die gruesomely while you dodge the bullets. Personally there have been moments when I’ve felt a sense of doom, it’s as if I’m a death row inmate, but with no certainty of when my execution will actually occur.

I have some extremely important advice to give to myself and to anyone else being treated for cancer.

1. Resist the temptation to compare the disease in your body to what is happening to other people fighting cancer, even if your condition seems highly similar.

2. Don’t dwell on statistics or the possibility of recurrence.

For instance, most women with ovarian cancer do have at least one relapse within five years of being diagnosed, but that standard rate of recurrence won’t necessary happen to me. The reality is that medical science has proven that all cancer patients are unique. What’s more, because cancer statistics are based on large groups of people, they cannot be used to predict exactly what will happen to you. Everyone is different. Treatments and how people respond to treatment can differ greatly. A well-known American cancer survivor, Joanna Montgomery, chronicles her experiences of treatment, motherhood and marriage in a personal blog called It’s Cancer, Baby. As Montgomery heavily underscored in one of her online articles, we are all individuals.

“The truth is that every single person’s cancer is different —even those diagnosed as the same type and stage —because that cancer exists in a unique human body unlike no other, with a unique life history and genealogy. I’ve met people with cancer of a lesser stage than mine who didn’t make it, while I’ve just as frequently met survivors who dealt with higher stages of cancer decades in the past and are still going strong. There’s no algorithm that will determine which of us will make it and which of us won’t. There are endless factors at play, and cancer is unpredictable and constantly morphing.”

The stress and anxiety generated from trying to predict what will happen to you or from scrutinizing other cancer patients might actually be detrimental to your health and the healing process. Medical science acknowledges a connection between our thoughts and emotions and certain physical aspects of healing, such as our immune system. The power of the mind-body connection has been widely accepted by mainstream medicine since the 1960s or 1970s. During those decades, a great deal of research in the field of biofeedback and self-regulation showed that human beings could learn to control many physiological functions. Even those ones that had previously been thought involuntary, such as heart rate and blood pressure, were found to be at least partially under our control. A number of pioneering studies drew on relaxation, meditation and yoga.

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The power we possess over own bodies and our personal health and the case for each of us being a unique biological organism was also established in a groundbreaking book entitled Mind as Healer, Mind as Slayer. In 1977, this book by Dr. Kenneth Pelletier helped to inspire widespread interest in mind-body interactions. Pelletier presents a variety of compelling evidence that the mind is a major participant in illness and that the mind can be a major factor in health as well. The majority of his case studies focused on serious chronic diseases, including heart disease and cancer.

So my recommendation if you are fighting cancer is to maintain faith in your body’s ability to heal itself. Even more importantly remember that your cancer journey is unlike anyone else’s and that your outcome may be radically different from those in similar medical circumstances. You are special, your body and spirit are both unique, so don’t assume you can predict the course your cancer will take simply by observing the disease in others.