Worried about cancer? Ask someone to marry you

 

Bloomberg News

When I mentioned my bout with breast cancer to a new acquaintance, his first question was, “Are you married?”

It was an unusual reaction — a more common query is whether I have kids. Later he told me that his daughter-in-law had been diagnosed with breast cancer while still in graduate school and that she and his son had moved in with him. He understood better than most people that being married makes it easier to cope with cancer.

The very next day the Journal of Clinical Oncology released a study offering more than anecdotal evidence that marriage is good for cancer patients.

Controlling for demographic factors such as age, race, education and household income, researchers who analyzed records of more than 730,000 cancer patients found that married patients did significantly better than single people. They lived longer, received better treatment and were more likely to be diagnosed before metastatic cancers developed.

It didn’t matter whether the unmarried patients were lifelong singles, divorced, widowed or separated. All did worse than demographically similar married patients.

“This study is the first to show a consistent and significant benefit of marriage on survival among each of the 10 leading causes of cancer-related death in the United States — lung, colorectal, breast, pancreatic, prostate, liver/bile duct, non-Hodgkin lymphoma, head and neck, ovarian and esophageal cancer,” the American Society of Clinical Oncology noted in its news release.

The study doesn’t explain exactly why marriage makes a difference. It’s possible that married patients just have better health insurance. But, the authors note, “even in nations with universal access to free care, such as Denmark, sociodemographic factors affect outcome in a multitude of health conditions.” (Insurance differences also wouldn’t do much to explain the disadvantage of widowhood, because widows tend to be covered by Medicare.)

“The most likely reason,” the authors conclude, “is that married patients have better adherence with prescribed treatments than unmarried patients.” They have someone to watch over them.

What about couples who aren’t formally married but in long- term relationships? What about widows with supportive kids? What about people with great friends? And what about unhappy marriages?

The study didn’t leave these people out. If it had — if it had measured only the difference between ideal marriages and lonely, miserable singles — the differences would presumably be even more distinct. In the big picture, marriage makes a difference.

Marriage is increasingly the big sociological divide in American life. Getting and staying married makes you part of a privileged elite.

As Charles Murray documents in his 2012 book Coming Apart, that divide tracks the income divide, with low-income whites much less likely to be married than their high-income counterparts. (I criticized a different aspect of Murray’s book in this column.) The causality is debatable. Maybe poorer people have a harder time getting married. Maybe being married makes it easier to earn more. Maybe some third factor causes both phenomena. But what is clear is that you’re most likely to have a better life if you’re married — even if, it turns out, you get cancer.

Friends are nice, but they are rarely equivalent to a spouse. The level of on-call commitment and intimacy is simply different. Your spouse knows you in a 24/7 way that few if any others do, especially in a society organized around the nuclear family rather than the extended one. (A spouse also multiplies your extended family by two.) As my economist husband likes to put it, being married also creates a “joint utility function.” Your happiness becomes entwined with your spouse’s, giving you strong incentives to make an extra effort.

Recalling how the “epidemic of care giving” in response to AIDS helped make the case for same-sex marriage, the writer Jonathan Rauch argued that by “assuming the burdens of marriage at its hardest,” gay men demonstrated that “no relative, government program or charity is as dependable or consoling as a dedicated partner.” What’s true of AIDS is true of cancer as well.

People don’t like to hear that. It’s not fair to single people. It’s not constructive. “Our results suggest that patients who are not married should reach out to friends, cancer support or faith-based groups, and their doctors to obtain adequate social support,” lead author Ayal Aizer, chief resident in radiation oncology at Harvard Medical School, said in the oncology society’s news release.

But trying to turn the study’s findings into a general call for “social support” ignores its stark result. Single people aren’t, of course, doomed to die of cancer. Their friends and family can in fact help them do better. But we shouldn’t pretend that marriage isn’t a huge advantage.

Virginia Postrel is a Bloomberg View columnist. Her next book, “The Power of Glamour,” will be published Nov. 5 by Simon & Schuster.

© 2013, Bloomberg News

Read more From Our Inbox stories from the Miami Herald

  • High drama in Texas governor’s office

    As moments of high political drama go, it doesn’t get much better than this. Indicted Gov. Rick Perry, we’re ready for your close-up.

  • The ones left behind

    The fire this time is about invisibility. Our society expects the police to keep unemployed, poorly educated African-American men out of sight and out of mind. When they suddenly take center stage, illuminated by the flash and flicker of Molotov cocktails, we feign surprise.

  • Whistle blower’s tale with happy ending

    Late last month, the Securities and Exchange Commission issued an oblique news release announcing that it was awarding an unnamed whistle-blower $400,000 for helping expose a financial fraud at an unnamed company. The money was the latest whistle-blower award — there have been 13 so far — paid as part of the Dodd-Frank financial reform law, which includes both protections for whistle-blowers and financial awards when their information leads to fines of more than $1 million.

Miami Herald

Join the
Discussion

The Miami Herald is pleased to provide this opportunity to share information, experiences and observations about what's in the news. Some of the comments may be reprinted elsewhere on the site or in the newspaper. We encourage lively, open debate on the issues of the day, and ask that you refrain from profanity, hate speech, personal comments and remarks that are off point. Thank you for taking the time to offer your thoughts.

The Miami Herald uses Facebook's commenting system. You need to log in with a Facebook account in order to comment. If you have questions about commenting with your Facebook account, click here.

Have a news tip? You can send it anonymously. Click here to send us your tip - or - consider joining the Public Insight Network and become a source for The Miami Herald and el Nuevo Herald.

Hide Comments

This affects comments on all stories.

Cancel OK

  • Marketplace

Today's Circulars

  • Quick Job Search

Enter Keyword(s) Enter City Select a State Select a Category