Breast and Ovarian Cancer Genetic Testing May Affect Marital Satisfaction
PHILADELPHIA (June 9, 2000) -- A new study examining the effects of cancer genetic testing on spouses shows that both husbands and wives can affect each other's emotional well-being and marital satisfaction during the testing process. The preliminary data from the Fox Chase Cancer Center and Georgetown University Medical Center study will be presented at the "Era of Hope" Department of Defense Breast Cancer Research Program meeting in Atlanta, Georgia on Friday June 9, 2000.
Researchers are using several standardized and study-specific psychological surveys to examine general and cancer-related emotional distress, marital quality and spousal supportiveness of couples in which the wife is being tested for mutations in the breast and ovarian cancer genes. Although earlier research has explored the psychological impact of genetic testing on participants, no known studies have examined the impact on spouses or the contribution of marital quality to participants' distress.
Preliminary study data collected at the beginning of the testing process, prior to disclosure of the genetic test results, indicate that a husband may substantially influence his wife's anxiety level by lowering distress with supportive behavior and heightening it with unsupportive responses. Similarly, the results also find that the wife can influence her husband's level of distress.
"Supportive spouses are defined as those who talk about the decision to pursue genetic testing, share their concerns about the testing process, discuss the subject freely, and provide encouragement consistently," explained Sharon Manne, Ph.D., behavioral researcher at Fox Chase Cancer Center and the study's principal investigator. "Unsupportive spouses are defined as those who may avoid discussion about the genetic testing.
"This is a common phenomenon called 'protective buffering.' A spouse may avoid talking about a subject because he or she doesn't want to burden the other partner. Although this is mostly a well-intentioned behavior, this avoidance is actually perceived by the other partner as being unsupportive and leads to more distress and relationship strain."
The study participants are surveyed at four time periods: at baseline (before participants receive genetic counseling and testing), and at one month, six months, and one year after couples know the genetic test results. "Once we have the final data, we hope that it will help us to identify genetic testing participants and spouses who may need special counseling to deal with the testing process and adjust to test results," said Manne.
To date, baseline evaluations are available for 143 wives and 117 husbands involved in the genetic testing program at Georgetown University. Dr. Manne is conducting the study at Fox Chase Cancer Center in collaboration with Janet Audrain, Ph.D., and Caryn Lerman, Ph.D., of Georgetown. Enrollment in the study will continue for another six months. At the "Era of Hope" meeting, Dr. Manne will present data for participants who have completed surveys through the one-month follow-up.
Individuals undergo testing for mutations in the genes BRCA1 and BRCA2 - the two mutations known to be associated with inherited risk of breast and ovarian cancer because they have a strong family history of the disease. Some have already been treated for breast cancer and want to clarify their family's risk, use test results to make decisions about self-monitoring and make decisions about childbearing.
Fox Chase Cancer Center, one of the nation's first comprehensive cancer centers designated by the National Cancer Institute in 1974, conducts basic and clinical research; programs of prevention, detection and treatment of cancer; and community outreach. For more information about Fox Chase activities, visit the Center's web site at: www.fccc.edu.
Fox Chase Cancer Center, part of the Temple University Health System, is one of the leading cancer research and treatment centers in the United States. Founded in 1904 in Philadelphia as one of the nation’s first cancer hospitals, Fox Chase was also among the first institutions to be designated a National Cancer Institute Comprehensive Cancer Center in 1974. Fox Chase researchers have won the highest awards in their fields, including two Nobel Prizes. Fox Chase physicians are also routinely recognized in national rankings, and the Center’s nursing program has received the Magnet recognition for excellence four consecutive times. Today, Fox Chase conducts a broad array of nationally competitive basic, translational, and clinical research, with special programs in cancer prevention, detection, survivorship, and community outreach. For more information, call 1-888-FOX CHASE or (1-888-369-2427).