A week after Joy was diagnosed with HER2+ Breast Cancer, her husband asked for a divorce.  The divorce did not deter the arrival of chemotherapy, a double mastectomy and radiation treatment.

Even the most amicable divorce can be debilitating. Add a cancer diagnosis to the mix and you have cancer patients whose quality of care and quality of life can be adversely affected.⁽¹⁾

Although oncology professionals may attain training to help others battle cancer, they often wonder what to do when their patient is also facing a separation or divorce. Or perhaps you reading are the one going through a divorce or maybe you have a loved one that is currently facing this reality. This information may be of help to you too! Here are three suggestions that the current cancer literature suggests.

3 Ways to Help When Divorce and Cancer Treatment is the Reality

1. Be Vigilant

Life does not stop just because a person is diagnosed with cancer. Recognize marital strife and taking actions to prevent a divorce is undoubtedly the best outcome. Therefore, begin by identifying which cancer patients are high risk for a divorce or separation after diagnosis.

Risk indicators for men and women:

• lower income
• younger age
• longer time since diagnosis

Risk indicators for women only:

• greater emotional distress
• employment and financial problems

Risk indicators for men only:

• fear of cancer recurrence ⁽²⁾

Patients and their partners may ignore, deny or disregard the notion that solving their couple and cancer-related problems may benefit them both through treatment and beyond. ⁽³⁾ Carol, a 6-year breast cancer survivor, had still not forgiven her husband for not coming to any of her chemotherapy treatments. These hurts do not disappear with the last treatment. During treatment, someone recognizing the patient’s discontent with this pattern and suggesting additional support or counseling would have been helpful to all involved.

2. Be Proactive

It’s easy to think “They just need to get through their cancer treatment and then they can deal with their divorce.” Unfortunately, studies show that the patient’s body does not wait to reveal the impact of divorce. Divorce makes cancer patients sicker and their lives shorter. ⁽⁴⁾

Compared with long-term married patients, newly divorced patients and long-term divorced were

• Most likely to be diagnosed with advanced disease.
• Least likely to receive curative treatment. ⁽⁵⁾

One study showed that newly divorced patients have the worst cancer-specific survival rate, followed by long-term divorced patients. ⁽⁶⁾

Just as obesity, alcohol and tobacco are serious cancer risk factors, divorce should be on this list as well.⁽⁷⁾ One study suggests that recent divorce should be seen as a risk factor for worse cancer outcomes, and encourages appropriate screening, treatment, and access to social and financial supports for recently divorced patients. ⁽⁸⁾

3. Be Supportive

It is no surprise that divorce represents an acute disruption of a patient’s social support network. ⁽⁹⁾ The disruption of a cancer patient’s social support can result in an increase in:

• anxiety
• depression ⁽¹⁰⁾
• hopelessness ⁽¹¹⁾

Of course, the burden of supporting a cancer patient undergoing divorce should never fall on one person. Joy received the additional support she needed from her sister, girlfriends and her faith. Remember to encourage your patient to seek additional support from not just family and friends but a support group and a counselor as well.

It is important to not just comprehend but remember that divorced or separated cancer survivors experience a heightened vulnerability compared to survivors whose relationships remained intact, ⁽¹²⁾ Although no one has a solution to alleviate their strife, compassionate care and awareness can make a difference.

Resources

1. Glantz, Michael J., et al. “Gender disparity in the rate of partner abandonment in patients with serious medical illness.” gov, National Insitute of Health, 15 Nov. 2009, pubmed.ncbi.nlm.nih.gov/19645027/ .
2. Stephens, C., Westmaas, J.L., Kim, J. et al. Gender differences in associations between cancer-related problems and relationship dissolution among cancer survivors. J Cancer Surviv 10, 865–873 (2016). https://doi.org/10.1007/s11764-016-0532-9
3. Ibid.
4. Dinh, Kathryn T., et al. “Increased Vulnerability to Poorer Cancer-Specific Outcomes Following Recent Divorce.” The American Journal of Medicine, Elsevier, May 2018, sciencedirect.com/science/article/abs/pii/S0002934317312330
5. Ibid.
6. Ibid.
7. “Risk Factors for Cancer.” Cancer.gov, National Cancer Institute, 23 Dec. 2015, www.cancer.gov/about-cancer/causes-prevention/risk .
8. Dinh, Kathryn T., et al. “Increased Vulnerability to Poorer Cancer-Specific Outcomes Following Recent Divorce.” The American Journal of Medicine, Elsevier, May 2018, sciencedirect.com/science/article/abs/pii/S0002934317312330
9. Ibid.
10. Hu, Tinji, et al. “Relationship between resilience, social support as well as anxiety/depression of lung cancer patients: A cross-sectional observation study.” Journal of Cancer Research and Therapeutics, Association of Radiation Oncologists of India, 8 Mar. 2018, cancerjournal.net/article.asp?issn=0973-1482;year=2018;volume=14;issue=1;spage=72;epage=77;aulast=Hu
11. Oztunc, G., Yesil, P., Paydas, S., & Erdogan, S. (2013). Social Support and Hopelessness in Patients with Breast Cancer. Asian Pacific Journal of Cancer Prevention, 14(1), 571–578. https://doi.org/10.7314/apjcp.2013.14.1.571
12. Stephens, C., Westmaas, J.L., Kim, J. et al. Gender differences in associations between cancer-related problems and relationship dissolution among cancer survivors. J Cancer Surviv 10, 865–873 (2016). https://doi.org/10.1007/s11764-016-0532-9