• 11/22/2004
  • Chris Birk
  • Scrantontimes.com

“I didn’t accept it as much as Mary (his wife) did,” he said. “I had a tough time.”

“With me and our children, he managed to pull through,” said Mrs. McHale.

“Especially you, Mary,” said her husband.

Science says he may be right. Male cancer patients with wives or live-in partners have significantly higher survival rates than those who don’t, according to a national study — analyzing 1,822 people with head and neck cancer — that included patients treated at Mercy Hospital in Scranton by local physician and cancer specialist Dr. Harmar D. Brereton.

The intriguing, if intuitive, results were culled by a national team of physicians and coordinated through the Radiation Therapy Oncology Group, a cancer research base in Philadelphia. But the study, presented at a June conference, posits a rather one-sided worldview: Female patients with partners don’t live any longer than those without.

Explaining the absence of a supportive quid pro quo invites a host of social speculation. But Dr. Brereton is hopeful the new information will eventually help improve the lives of all cancer patients, regardless of gender.

“The wonderful thing that came up, and it’s something that all doctors know, is if you’re married, you can’t imagine how valuable that asset is in going through your treatment,” said Dr. Brereton, of the Northeast Radiation Oncology Center in Dunmore. “Now that we’re showing there’s a real statistically significant survival advantage to that circumstance, how can we arrange for something that is a facsimile of that for people who don’t have it?”

Power of partnership

In his own travels, Dr. Brereton, who served as head of radiation medicine at the National Cancer Institute in Maryland, had treated enough married couples to understand the power of partnership. To study the relationship, doctors pooled data from three separate cancer studies, which included various characteristics of each patient, including marital status.

The physicians chose to focus on head and neck cancer, a particularly debilitating form that can severely limit a patient’s ability to speak or eat on his or her own. While treading lightly around traditional gender roles, Dr. Brereton said the almost instinctive results hearken to the nurturing nature of women.

“If men are married, we immediately know we can use their wives as resources,” he said. “If you have a wife, and most women are really good at this — of knowing their husbands and helping them get through it — it makes a difference in their survival.”

Applying findings

While the results are somewhat unsurprising, the study’s findings can be used to direct care for men without a wife or live-in significant other, said Dr. Brereton. He said the simple cause-and-effect underscores the importance of learning a patient’s social structure, living arrangements to relationships.

For example, men without a partner should get constant, daily care from nurses, he said. Other services, such as psychological counseling, nutritional information and social wellness, could be tied into a treatment facility’s master plan.

“I think what it tells us is as we screen patients for care, we need to make sure we’re taking a full assessment of their social as well as their medical and physical conditions,” said Dr. Walter Curran, professor and chairman of radiation oncology at Jefferson Medical School in Philadelphia and RTOG group chairman. “We really hope that this also gives a message that things such as social support for patients is appropriately supported by third party payers.”

The flip-side of the study is the husband’s statistically nonexistent contribution to his wife’s health. While Dr. Brereton has witnessed many husbands help their wives through cancer recovery, he said the study’s conclusion is, generally, a reliable pattern.

Dr. Curran was at a loss to explain the gender differential. Calling the study “hypothesis generating,” he said the absence of a mutual benefit is a topic “we need to think about and understand.”

Much like coordinated efforts for single men, plans to help married men care for their spouses should also become a physician’s task, said Dr. Brereton, pointing to husbands who should strive to keep habits and routines, such as going to church or bingo, enjoyed by their wives.

The story of the McHales perhaps points to the longterm promise of the study — and of mutual support. While Mrs. McHale helped her husband pull through, she’s also a breast cancer survivor. They credit one another for their respective recoveries.

“I was shaken up when I first learned that she had cancer,” Mr. McHale said. “But I stood up to the task, I took care of her, went with her for all of her treatments. And I’m sure she could have went alone, that’s how strong she is.

“But I wanted to be with her, because she was with me.”

“I know there are a lot of people who do have to go it alone,” Mary said. “You need support.”