Women with MS or cancer more likely to divorce

From The Deseret News in Utah:

Women diagnosed with cancer or multiple sclerosis are over six times more likely to be divorced than men with the same diagnosis, according to a new study co-authored by a former researcher at the Huntsman Cancer Institute.

And while none of the study subjects came from Utah hospitals, the results come as no surprise to an experienced local psychotherapist, who has seen the pattern replicated here despite the fact that Utahns place a high value on marriage and family support.

Dr. Marc Chamberlain, chief of the division of neuro-oncology at the Seattle Cancer Care Alliance, said the study was undertaken after he and Dr. Michael Glantz, a fellow neurologist and former Huntsman researcher, noticed that several of their female patients experienced a divorce after their cancer diagnosis.

Published in the Nov. 15 issue of the journal Cancer, the survey of 515 married patients showed that while people with cancer were no more likely to divorce than the general population, for those whose marriages do end after diagnosis, "the woman was the affected spouse in nearly 90 percent of (those) separations."

"We don't actually know whether the patients were in discord or distress already, but we know they were married at the time of entry into the study (upon diagnosis)," Chamberlain said. "We have no idea whether there was any pre-existing discord."

Researchers also found that patients who had a long-term marriage also had a better chance of keeping their marriage intact, whether male or female.

Study subjects were treated at cancer centers based at the University of Massachusetts, Stanford and the University of Southern California, "which are fairly representative of America, but not necessarily African Americans, Asians or South Americans. So we're really looking at white, European-Caucasian bias," Chamberlain said.

Researchers did not survey for a family history of divorce or for religious affiliation, he said, so it isn't known whether those factors would have an impact on survey results.

The study may or may not be "relevant to Salt Lake City" or the population in Utah, he said. "You have a different community than many places in America and this may not be reflective of a community that has such a large faith-driven culture."

But Thomas Harrison, a local psychotherapist who has taught at the University of Utah Medical School and worked with conflict resolution and divorce mediation since 1977, said the study results ring true to his observations of how a sector of local men and women deal with the major medical problems.

He agrees with the study's assessment that because of the strength of the correlation between being female and the chance of divorce after diagnosis, "these findings apply generally to patients with life-altering medical illness."

"It takes men longer to make that deep attachment" within a marriage, he said. "And there is much more stigma attached to illness, more for men than women. Women will kick in and say 'here's my spouse and I'm going to nurse him,' while men are poorer at adapting to the role of caregiver and that domestic role, as well as the loss of a viable sexual partner."

"They don't adapt as well as women do," he said. "That's because their conceptualization of women is based on their 'doing' self more than their 'being' self. When something impairs women's ability to 'do' (for their husbands), his conceptualization of that person decreases and that's where the love and attraction base is coming from."

Because men are much more "objective" and women much more "subjective" in their relationships, men by nature focus on "performance" and women focus on "being," Harrison said.

Over time, Harrison said he's seen men "becoming more and more object-oriented. That's why I believe we have such a huge problem with pornography and objectifying women. It feeds into the process where men look at women more as objects. Their notion is 'what are you going to produce for me?' rather than 'what am I going to produce for you?'"

A telling analogy is men's obsession with sports, he said. When they identify with a team, "they take the loss personally. I find that the relationship and humor in the home is often based on whether the Cougars or the Jazz won because that team is providing men with their esteem."

The corollary when it comes to major illness for men is, "as long as she is doing and keeps up on the process then she is my social identity," he said.

"As long as she looks good and we're interacting and getting out there, that meets my needs. But if something happens to her and I have to change my work schedule," men often say, "this doesn't work for me. I'll go find somebody else."

The findings speak to women's commitment level "in sickness and in health" being "much stronger and more consistent when tested and tried than men," Harrison said.

"As a man, that's difficult and discouraging. But we have to look at it and help men move out of it," he said, particularly when divorce has such a major health impact at that point.

Chamberlain said the women he studied who were divorced after diagnosis "struggled to complete treatment, often didn't pursue further treatment at the time of disease progression. They had lower utilization of hospice, a higher incidence of depression, and were less likely to die at home."

At this point, researchers aren't sure how to identify women who are at risk when they are diagnosed with a life-altering illness, but "a subsequent study would be useful to answer that question for potential intervention," he said.