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Social Networks and Survival and Groups

Posted 8/3/2010

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Any of you who have been reading this with any regularity or who know me at all will know that I am a big fan of good support groups. Notice the adjective. Like any thing else in the world, support groups come in many flavors, and not all are equally helpful. The major fear about groups, often expressed by women as a reason they don't want to join one, is that they will hear about other frightening things and/or that they will go home weighted by others' troubles. In a well-led support group, that won't happen. It is the job of the facilitator to protect everyone in the room and to make sure that, although anxieties certainly are discussed, to be careful that they are also ameliorated. We come together to form a community that supports and holds us all.

Breast cancer support groups are organized in different ways. Personally, I feel strongly that groups are most helpful when they are comprised of women in similar situations. Therefore, I facilitate one group for women who are newly diagnosed or going through adjuvant treatment, another group for women who have completed treatment (not including hormonal therapies as those go on for years), and a third for women with metastatic breast cancer. There are others who believe that groups work best when they are open to a wider range of circumstances, so women at any stage of breast cancer may be included. If you are looking for a group, that is one of the two important questions to ask: Who comes? The other is Who leads the group?

All of that is prologue to this abstract about the value of social networks in survival after breast cancer. Although it is much more general and discusses the importance of a range of social connections, I can never pass up a chance to talk about groups. Here it is:

Journal Article

Social networks and survival after breast cancer diagnosis

Journal Journal of Cancer Survivorship

Publisher Springer New York

ISSN 1932-2259 (Print) 1932-2267 (Online)

DOI 10.1007/s11764-010-0139-5

Subject Collection Medicine

SpringerLink Date Friday, July 23, 2010

Jeannette M. Beasley1, Polly A. Newcomb2, 3 , Amy Trentham-Dietz3,

John M. Hampton3, Rachel M. Ceballos2, Linda Titus-Ernstoff4, Kathleen M. Egan5 and

Michelle D. Holmes6

(1) Cancer Prevention Program, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., M3-A410, Seattle,

WA 98109-1024, USA

(2) Cancer Prevention Program, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., M4-B402, Seattle,

WA 98109-1024, USA

(3) University of Wisconsin Paul P. Carbone Comprehensive Cancer Center, Madison, WI, USA

(4) Dartmouth Medical School, Lebanon, NH, USA

(5) H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA

(6) Channing Laboratory, Harvard Medical School, Brigham & Women's Hospital, Boston, MA, USA

Received: 28 August 2009 Accepted: 29 June 2010 Published online: 23 July 2010

Abstract

Introduction

Evidence has been inconsistent regarding the impact of social networks on survival after breast cancer diagnosis. We prospectively examined the relation between components of social integration and survival in a large cohort of breast cancer survivors.

Methods

Women (N = 4,589) diagnosed with invasive breast cancer were recruited from a population-

based, multi-center, case-control study. A median of 5.6 years (Interquartile Range 2.7-8.7) after breast cancer diagnosis, women completed a questionnaire on recent post-diagnosis social

networks and other lifestyle factors. Social networks were measured using components of the Berkman-Syme Social Networks Index to create a measure of social connectedness. Based on a search of the National Death Index, 552 deaths (146 related to breast cancer) were identified.

Adjusted hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards regression.

Results

Higher scores on a composite measure of social connectedness as determined by the frequency of contacts with family and friends, attendance of religious services, and participation in community

activities was associated with a 15-28% reduced risk of death from any cause (p-trend = 0.02).

Inverse trends were observed between all-cause mortality and frequency of attendance at religious services (p-trend = 0.0001) and hours per week engaged in community activities (p- = 0.0005). No material associations were identified between social networks and breast

cancer-specific mortality.

Conclusions

Engagement in activities outside the home was associated with lower overall mortality after breast cancer diagnosis.

Keywords Cancer - Oncology - Breast cancer - Survival - Mortality - Social

networks


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