Social Support May Impact Blood Cancer Outcomes

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Patients with blood cancers who had limited social support tended to have poorer survival and a higher likeliness to be hospitalized, recent research showed.

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Patients who are undergoing aggressive treatment for blood cancer tended to have poorer survival outcomes and a higher likeliness of being hospitalized if they are lacking social support, according to recent research published in the journal, JNCCN.

“In other health care settings, social support, or essentially, the surrounding support that you receive from loved ones, friends and really the entire community, is important,” study author, Dr. Patrick Connor Johnson, a lymphoma specialist at Massachusetts General Hospital Cancer Center and assistant professor of medicine at Harvard Medical School, said in an interview with CURE®. “We've seen this in other places in medicine, that this can affect outcomes. And so we wanted to have a greater understanding of how social support impacts those with aggressive blood cancers, which is a group of patients who undergo particularly aggressive treatments, which can be very intense in terms of the risk for side effects and the need for care.”

Medical Records Offer Insight to Social Support

Johnson and his team analyzed electronic medical records from 251 patients undergoing aggressive treatment for blood cancer (leukemia, lymphoma or myelodysplastic syndrome or a myeloproliferative neoplasm) and used a natural language processing algorithm to look for relevant words and phrases noted by treated clinicians that indicate social support, such as information about living situations and caregivers. The data was then used to rank patients’ levels of social support.

“We ran this algorithm to all those patients, and actually use that to be able to try and get a sense of whether patients had a higher level of social support or were more isolated by virtue of notes that were documenting certain things,” Johnson explained.

Findings showed that limited social support was associated with poorer overall survival (time from treatment or study enrollment to death of any cause), as well as hospital readmissions within 90 days.

Why Social Connections May Affect Outcomes

While this particular study was not designed to determine why limited social support was associated with poorer outcomes, Johnson has some theories, ranging from practical to emotional.

“Aggressive blood cancers typically are cancers that require an intense treatment; these treatments often have a high risk of side effects, they're often pretty complicated. So you may have to come back and forth to the hospital. If you develop a side effect, you may need to recognize that and call,” Johnson said. “You might imagine that if you have additional community support, family support, friends support to help you identify those side effects get to and from the hospital, and that that will give you a higher likelihood of getting through the treatment in a timely fashion.”

There may also be psychological factors at play here, too, according to Johnson.

“It's also having the additional layers of support to be able to identify and manage side effects, and staying on track with your treatment,” he said.

Where Patients Can Find Social Support

While these findings may be worrisome for patients who do not have social support, Johnson explained that there are ways that individuals can find these connections, even if they do not have them at home.

For example, for patients with blood cancer, nonprofits like the Leukemia & Lymphoma Society and the Lymphoma Research Foundation have programs that help patients connect with others who have similar diagnoses or help guide individuals through the treatment process, Johnson said.

Additionally, Johnson mentioned that most cancer treatment centers have social workers who can help patients through the cancer experience.

“Meeting with a social worker can be very important for trying to identify other aspects of life that are being affected (by cancer), and I think that everybody should meet with a social worker to try and think about how they can optimize support,” Johnson said.

Finally, Johnson said that people should think outside of marital or familial status regarding social support. He acknowledged that it is sometimes difficult to ask others — such as friends or community members — for help but leaning on people who are willing to help can be extremely beneficial for patients undergoing treatment for aggressive blood cancers.

“I think foundations are very important to think about, I think social work are very important. And then I also just think about thinking holistically about what social support means or is, and that's really the whole community or everybody who's potentially, in your life,” he said.

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