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When their husbands, wives or partners experience symptoms of depression, cancer survivors are more likely to develop depression themselves, say researchers at the U.S. National Cancer Institute (NCI).
The researchers noted that cancer survivors whose spouses who have good mental and physical health are less likely to suffer from depression after a year, suggesting that better spousal care might also benefit cancer survivors.
"Our research highlights that spouses need to take care of themselves not just for their own sake, but also for the sake of the cancer survivor," lead researcher Kristin Litzelman, a cancer prevention fellow in the NCI's Behavioral Research Program, said in a news release from the American Association for Cancer Research.
According to the researchers, there are roughly 14.5 million cancer survivors in the United States. Often, these people receive care and support from their family -- spouses, in particular. In addition to sharing the financial burden of treatment, spouses/partners may assist with care and provide other forms of support, such as going to medical appointments.
To examine these relationships, the researchers analyzed information compiled on more than 900 cancer patients and their spouses. Using statistical models, they considered how the quality of life or depressed mood of spouses affected cancer survivors' risk of also being depressed after 11 months. Then they compared these relationships to a group of couples who had not dealt with cancer or the lingering effects of cancer treatment.
The study, published June 1 in the journal Cancer Epidemiology, Biomarkers & Prevention, found that when spouses reported feeling depressed, cancer survivors were four times more likely to also develop symptoms of depression -- even after researchers took other factors into account, such as demographics. The link between the well-being of survivors and their spouses' mood was strongest when wives had cancer.
"Our findings also suggest that when caring for cancer survivors, clinicians may want to assess the well-being of spousal caregivers," Litzelman said. "Future research could test whether including caregivers in the survivorship care plan might help to improve outcomes for both caregivers and for cancer survivors."
There was good news from the study, too: When the "health-related quality of life" of the spousal caregiver improved, the researchers noted a 30 percent drop in the rate of depression in survivors 11 months later.
The relationship did not work in reverse: According to the researchers, the mood of the cancer survivors did not have a significant influence on their spouses' risk for depression.
"We were surprised that the effects of the spouses on the survivors were so much larger in this study than the effect of the survivors on their spouses," Litzelman said. "We expected to see a more reciprocal relationship."
One mental health expert wasn't surprised by the findings.
"This paper proves the common sense adage that you need to take care of yourself in order to be an effective caretaker of others," said Dr. Karen Mechanic, head of psychiatry at Fox Chase Cancer Center in Philadelphia.
"A cancer diagnosis can be traumatic and sends out a distress signal to others in your life, and it can also be isolating," she added. "Effective cancer care requires the participation of caregivers who are often part of the treatment decision-making process."
-- Mary Elizabeth Dallas
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