Women With More Social Connections Have Better Survival

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If you’ve been diagnosed with breast cancer, you know the support of your close friends and relatives as you move through the diagnosis, treatment, and recovery process is invaluable. A large body of research shows that people who are well connected to other people tend to have better health and are more likely to recover from serious medical issues.

A large study adds more evidence to support the power of social networks. Women diagnosed with breast cancer who had the most social ties, such as spouses, community relationships, friendships, and family members, were less likely to have the breast cancer come back (recur) and less likely to die from breast cancer than women who were socially isolated.

The research was published online on Dec. 12, 2016 by the journal Cancer. Read the abstract of “Postdiagnosis social networks and breast cancer mortality in the After Breast Cancer Pooling Project.”

In the study, which the researchers said is the largest study done so far on social networks and breast cancer survival, 9,267 women who had been diagnosed with all stages of breast cancer were asked about their personal relationships within two years of diagnosis.

Social networks are the web of personal relationships that surround an individual.

The women in the study were asked about:

  • spouses or partners
  • religious, community, and friendship ties
  • number of first-degree, living relatives

First-degree relatives are parents and siblings.

The women were followed for up to 20 years.

The researchers classified the women based on the number of social connections they had:

  • socially isolated women had few social ties
  • moderately integrated women had some social ties
  • socially integrated women had many social ties

Compared to socially integrated women, socially isolated women were:

  • 43% more likely to have a breast cancer recurrence
  • 64% more likely to die from breast cancer
  • 69% more likely to die from any cause

"It is well established that women who have more social ties generally, including those with breast cancer, have a lower risk of death overall," said Candyce H. Kroenke, Sc.D., M.P.H., research scientist with the Kaiser Permanente Northern California Division of Research and lead author of the study. "Our findings demonstrate the beneficial influence of women's social ties on breast cancer-specific outcomes, including recurrence and breast cancer death."

Still, Kroenke pointed out that not all types of social ties were beneficial to all women.

For example, the researchers found that older white women without a spouse or partner were 37% more likely to die from breast cancer than older white women with one. This relationship wasn’t seen in other groups.

Non-white women with few friendships were 40% more likely to die from breast cancer than those with many friendship ties. Non-white women with fewer relatives also were 33% more likely to die from breast cancer than those with many relatives. These relationships were not seen in white women.

"The types of social ties that mattered for women with breast cancer differed by sociodemographic factors including race/ethnicity, age, and country of origin," Kroenke said. "Ultimately, this research may be able to help doctors tailor clinical interventions regarding social support for breast cancer patients based on the particular needs of women in different sociodemographic groups."

It’s important to know that the study does have some limitations. The make-up of women in the study doesn’t reflect women diagnosed with breast cancer in the United States. Fewer than 5% of the women in the study were black or Hispanic. Also, most of the women in the study had been diagnosed with early-stage disease -- very few women had metastatic breast cancer. So it’s hard to know how broadly the results can be applied. It’s also hard to draw firm conclusions from this study because it’s difficult to accurately measure social ties.

Still, it seems clear that having regular social connections can make your life better, even if you consider yourself shy or a loner. Sharing joys and fears -- being open about what’s really going on inside -- helps us to connect with each other. Being diagnosed with cancer is scary, and both you and your loved ones may respond to that stress in different ways. You may feel the urge to pull away or think that people expect you to put on a brave face. Loved ones may seem distant because they don’t know what to say or how to help. They also might be afraid of losing you.

Try to be honest and clear about what you’re feeling. Then think about what you really want or need from your spouse or friends. Do you want someone to go with you to appointments? Do you want someone to just listen to your fears without trying to “solve” them? Do you want to be held? Ask for what you need directly. Don’t assume that anyone knows what you need. You might feel uncomfortable asking for help. But by asking directly for what you need, you’re actually giving your family and friends a gift: a clear opportunity to support you with what you need and want most.

For more information on how to broaden your social networks, check out Marisa Weiss, M.D.’s Think Pink, Live Green column, “Family and Friends Can Benefit Your Health.”



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