Conditions

After Your Cancer Diagnosis, Who Supports Most: Family & Friends or Peers?

Cancer Patient
Researchers found that greater emotional support was related to better mental well-being. jennifrog, Creative Commons

If you were diagnosed with cancer, let's say tomorrow, do you believe your current network of family and friends would be helpful (and healthful) for you? Or would a peer, another person dealing with cancer, support you more?

This question of who supports most after a cancer diagnosis has long interested researchers studying the benefits of peer-discussion groups. Although various methods of investigation have been employed, one study published in Social Science & Medicine best lays the ground work for this issue by asking, Is emotional support, as most people assume, related to well-being?  

Aftermath of Cancer Diagnosis

What exactly happens in the first few moments, hours and days following a diagnosis of breast cancer?

Researchers at the School of Public Health, University of California, theorized that women begin to draw resources from their network of friends and relatives, resources that include both emotional support and instrumental resources, such as getting a ride to a medical appointment.

Hypothesizing that emotional support buffers the women from stress and improves their mental well-being while the existence of instrumental support would lead to greater physical well-being, the researchers tested a cohort of 336 women in the US. Mainly married (65%), employed (75%), with dependent children (63%), and having undergone a mastectomy (51%), all had been diagnosed and were being treated for breast cancer at age 50 or younger.

Consistent with their predictions, the researchers found that greater emotional support was most definitely related to better mental well-being. Yet the size of a patient's social network mattered, too, as more people amounted to greater emotional support; it also related to greater instrumental support.  

The thread of these findings was soon followed by other researchers.

Support from Education Group or Peer Group?

Although many people sense that a peer, who is also undergoing cancer treatment, might provide support that family and friends simply cannot deliver, the benefits of peer-discussion groups have never conclusively demonstrated positive effects. In fact, among cancer patients, education groups seem to better fit the bill than peer discussion groups. One reason for the inconsistent findings may have to do with patients' different needs for emotional support.

Or so researchers at Carnegie Mellon University and University of Pittsburgh imagined. In their study of a group of breast cancer patients, the researchers administered a quality of life instrument to measure the effects of an information-based educational group as compared to an emotion-focused peer discussion group. Their study indicated that a subgroup of women benefited from the peer-discussion group --- those who lacked emotional support from their partners or who reported more negative interactions with their partners.

Shockingly, the women who started out satisfied with the level of emotional support received from their partner actually deteriorated over time in physical functioning when assigned to a peer-discussion group.

How could a peer group harm these women?

It may be that attending a peer-discussion group altered these women's perceptions of their relationships. "Women who came to the group and perceived their network relationships to be helpful may hear stories from other group members that lead them to reevaluate their existing social relationships," write the authors. In an earlier study, the researchers indicated that negative interactions with network members increased over time for people in the peer discussion conditions.

Although this study finds people with solid social networks may not benefit from a peer-discussion group, they are still thought by many to be beneficial because they compensate for deficits in one's naturally occurring network. In the instance of cancer, as well as other stressful life events, it is likely that a portion of people receive effective support from their network and do not have such deficits. An Australian study challenged that view.

Cancer Diagnosis Empowerment & Agency

Two questions were examined by researchers in Sydney: what do cancer support groups provide that other supportive relationships do not? And, what are the perceived consequences of support group attendance?

Nine representative cancer peer support groups, consisting of a total of 93 participants, 75 women and 18 men, with a mean age of 62, consented to observation and focus group interviews.  Researchers found that participants positioned support groups as providing a unique sense of community, unconditional acceptance, and information about cancer and its treatment, in contrast to the isolation, rejection, and lack of knowledge about cancer frequently experienced outside the group.

That said, participants also perceived the groups as 'occasionally' challenging on an emotional level in contrast to the experience of the normalizing support they received from family and friends.

The most significant consequences of group support consisted of increased empowerment and agency. Secondarily the participants said they had gained confidence and a sense of control in relation to themselves, living with cancer, and their interactions with others (in particular the medical profession). The participants also believed that attending the support group facilitated positive relationships with family and friends by relieving their burden of care and by providing a safe space for the expression of emotion.

"No difference was found between professionally led and peer led support groups, suggesting that it is not the professional background of the leader which is of importance, but whether the group provides a supportive environment, mutuality, and a sense of belonging, and whether it meets the perceived needs of those attending," state the authors.

In the end the most important finding of all these studies is that emotional support is what matters to those currently dealing with cancer as well as those who may face this disease somewhere down the line.

 

Sources: Ussher J, Kirsten L, Butow P, Sandoval M. What do cancer support groups provide which other supportive relationships do not? The experience of peer support groups for people with cancer. Social Science & Medicine. 2005.

Bloom, JR, Stewart, SL, Johnston, M, Banks, P, Fobair, P. Sources of support and the physical and mental well-being of young women with breast cancer. Social Science & Medicine. 2001.

Helgeson, VS, Cohen, S, Schulz, R, Yasko, J. Group Support Interventions for Women With Breast Cancer: Who Benefits From What? Health Psychology. 2000.

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