Closeness of Partners During Cancer May Help Keep Symptom Burden Low

Partners who remain close during cancer-related discussions may protect the person with the disease from experiencing increased symptom burden, according to study findings presented during the American Society of Clinical Oncology (ASCO) Palliative and Supportive Care in Oncology Symposium.

Researchers from The University of Texas MD Anderson Cancer Center in Houston examined attachment style of patients with metastatic non-small cell lung cancer, who often have a poor prognosis, and their partners.

Attachment style dates back to the late 1960s and describes the ways in which children respond when they are separated from their primary caregiver. It is often developed in the first year of life, lead author Kathrin Milbury, Ph.D., an associate professor at MD Anderson, explained in an interview with CURE. Children can be securely attached, anxiously attached or avoidantly attached. If a child is securely attached, it means they are happy when reunited. For those who are anxious, they may become clingy or overexcited. And children who are avoidant may give a caregiver the cold shoulder.

“This very early attachment style gets hardwired into our brains and as people grow up throughout their adulthood this attachment paradigm shows up most commonly in romantic relationships,” Milbury said. “In times of stress we can either solicit support from our partner and feel good about receiving support, avoid it and don’t depend on anyone or the anxious ones become preoccupied with the partner not loving them, the partner leaving them, and they don’t feel secure in their relationship.”

Researchers asked patients and their partners — the median time together was 27 years — to compete surveys that assessed attachment and emotional closeness during cancer-related discussions. In addition, patients self-reported symptom burden on a 13-point scale and how it affected their daily living. Physical symptoms were low; however, sadness and distress were most common regarding psychological symptoms.

Just over half (51 percent) of patients were women and the majority (80 percent) were white. The median age was 65 years old. Partners were also mainly women (51 percent) and white (68 percent). The median age was 64 years old.

Researchers found that patients who had high attachment avoidance had significantly higher cancer symptoms compared with patients who had secure attachment. In addition, symptoms were also significantly higher for patients whose partners reported low closeness compared with those who reported high closeness during cancer-related discussions.

“The good news is that (people) can be rewired so to speak,” Milbury said. “Usually, it’s through counseling or support of a supportive partner. If their partner can maintain intimacy as they are discussing cancer-related concerns, it protects the patient from the consequences of an avoidant attachment style. The partner can function almost as a buffer.”

It is important for patients and partners to view cancer as something that affects the entire family, explained Milbury. “We see that especially male patients engage in protective buffering and they don’t want to talk about their worries because they don’t want to burden their family,” she said. “While that is well-intended, it hinders closeness and emotional intimacy. Do not be afraid to share your worries and concerns. And if someone shares worries and concerns, be there and listen. Don’t try to fix it.”