Cancer and Social Support

Social Support and the Immune System

Medical researcher Dr. Janice Kiecolt-Glaser

Psychoneuroimmunology researchers have consistently found a positive correlation between social support and the immune system.

Medical researcher Dr. Janice Kiecolt-Glaser has proven that social support improves immune function and can reverse the damaging physiological effects of emotional distress. She found that social support improved leukocyte cell counts and immune function.

College students are under enormous emotional distress during exam periods. At Ohio State University, students were interviewed prior to a period of final exams to determine their baseline emotional distress levels as well as their level of social support. Researchers collected saliva samples before, during, and after the exam period. (Researchers often use salivary immunoglobulin A (s-IgA) because it is one of the few lab measures they can collect noninvasively.) Researcher Susan Kennedy, working in Dr. Kiecolt-Glaser’s lab, found that s-IgA was significantly diminished in the emotionally distressed students who lacked good social support, making them more vulnerable to both bacterial and viral respiratory diseases. The students with good social support had far less diminution of their s-IgA as well as higher levels of s-IgA during all three collections.

In other studies by these Ohio State researchers, they measured natural killer (NK) cells during stressful periods. Reductions in NK cells correlated with lower levels of social support. The significance of this finding is that people without social support are more likely to develop cancer because NK cells attack and destroy cancer cells after the cancer cells are flagged by CD-4 (T-Helper) cells.

Dr. Kiecolt-Glaser’s husband, Ronald Glaser is also a psychoneuroimmunology researcher. In one of his studies, forty-eight medical students at Ohio State Medical School received inoculations of the standard series of three injections of hepatitis B vaccine on days that coincided with a very stressful exam period. His remarkable finding was that the students who reported having the most social support produced the most antibodies in response to the vaccine. These same students also manifested the most robust T-cell responses to the hepatitis B surface antigen. (Antigens are the substances that initially provoke the immune response. Antibodies are the proteins that are secreted as a result of the antigen-triggered immune response.)

 Social Support and Cancer

In a substantial study of three thousand breast cancer patients, all of whom were nurses, completed in 2006, researchers found that women without close friends had a mortality rate of four times that of women with a close circle of friends.

In another study of 514 women, 239 were diagnosed with breast cancer. One of the results of this study was that those with the least social support were nine times as likely to develop cancer following a stressful life event. In fact, most psychooncology studies have found a positive correlation between survival time after cancer diagnosis and the amount and quality of social support.

Dr. Elizabeth Maunsell

Epidemiology researcher Dr. Elizabeth Maunsell  interviewed 244 breast cancer patients, asking them how many people they had confided in during the three months post surgery. They followed up with the patients for several years, and these were the results:

• The seven-year survival rate for the patients who had not confided in anyone during that three-month post-surgery period was 56 percent.
• The survival rate for those who had confided in one person was 66 percent.
• Those who had confided in two or more people had a 76 percent survival rate.

POW Reports

Further evidence for the essentialness of social support can be found even in the extremity of war. Tortured POWs have reported that being separated and isolated from their trusted comrades could be even worse than the physical torture inflicted on them. This is why it is standard practice for torturers to separate all the members of a captured platoon. It is common knowledge that keeping captured soldiers together can empower them, whereas isolating them has the reverse effect.

 The Lesson of Roseto

Roseto, Pennsylvania, was a small community made up exclusively of Italian immigrants. Physician Stewart Wolf studied this town in the late 1950s and again in the 1970s. In the 1950s, Roseto residents’ health habits were awful. They chain-smoked cigarettes, drank, did not exercise, and ate a red meat diet that was even higher in fat and cholesterol than the typical American diet of that era. They worked in mines, breathing filthy air all day, and lived in an environmentally unhealthy area. Their incidence of obesity and hypertension was equal to those in surrounding towns. Despite their abysmal health habits, the Roseto men had one-sixth the incidence of heart disease compared to other American men.

A generation later in the mid-1970s, Dr. Wolf and his original research team again looked closely at the residents of Roseto and discovered that they now had the same morbidity and mortality rates as the people of the surrounding towns. Referring to the 1950s study, here is what the researchers concluded:

 “More than any other town we studied, Roseto’s social structure reflected old-world values and traditions. There was a remarkable cohesiveness and sense of unconditional support within the community. Family ties were very strong. And what impressed us most was the attitude toward the elderly. In Roseto, the older residents weren’t put on the shelf; they were promoted to “supreme court.” No one was ever abandoned.”