November 8, 2017
The importance of a partner in cancer therapy
Whether or not a patient is married is an understood predictor in clinical outcomes, including in patients with cancer. While researchers know that partnered patients have better overall survival than unmarried patients, it is unknown exactly why.
To further investigate this issue, Christine M. Veenstra, MD, MSHP, IHPI member and a medical oncologist at U-M's Comprehensive Cancer Center, set out to study outcomes among patients with stage III colon cancer, comparing the treatment and outcomes of patients who were married or partnered against those who were not.
Veenstra and colleagues examined medical records for nearly 400 patients within the Michigan Cancer Research Consortium with stage III colon cancer, noting their partnered status, and compared the treatment that the patients received to the recommendations from the National Comprehensive Cancer Network® (NCCN®) as outlined in the 2015 version of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Colon Cancer.
According to Veenstra, because the NCCN Guidelines® for stage III resected colon cancer are clear, comprehensive, and evidence-based, they provide an excellent case for investigating concordance. The protocol outlined in the 2015 Guidelines included surgery, followed by six months of adjuvant chemotherapy, preferably two-drug combination chemotherapy.
While 85% of the patients studied received either combination or single-agent chemotherapy, partnered patients were far more likely to complete the six-month course, perhaps also increasing their likelihood of overall survival.
“We found that patients who had a partner were almost twice as likely to complete the full six months of chemotherapy. This finding is important as it points to a possible mechanism for improved outcomes that we had not recognized earlier,” said Veenstra.
Although the state of partnership does not change the physical characteristics of one’s cancer or the likelihood of his or her response to treatment, there are theories for this disparity. Regarding the specific treatments outlined in this study, the most common side effect and reason patients give for stopping treatment was neuropathy.
“Partners may help patients manage and cope with the physical side effects of treatment, as well as provide important encouragement and positive support that unpartnered patients do not necessarily have,” explained Veenstra. She also noted that general support could be a factor, such as someone to provide transportation or fill prescriptions at the pharmacy.
