While recovering from my own breast cancer surgery, there were long stretches when I felt alone, hungry, and in pain. I was afraid to get out of bed and walk down the stairs. Only I came to my little pity parties (there were several). My husband was out of town, I didn’t want to bother anyone else, and I didn’t feel like answering the phone. My pain was way worse and lasted far longer than it should have. Later, it occurred to me that feeling isolated, alone, and helpless during that time could have made my symptoms worse.
In fact, it probably did. A huge body of research — thousands of articles — shows that people who are well connected to other people tend to have better health. They have a lower risk of developing common health problems. They are more likely to recover from serious medical issues, such as breast cancer and heart attacks. Also, people who are connected to other people tend to live longer than people without strong social ties.
That makes sense. People are social animals. We have a deep need to feel connected to each other. At the same time, we all need alone time. Many people live alone by choice, for all kinds of reasons. Still, strong social connections can help us be as healthy as possible.
The power of people
Three types of support from family and friends are especially helpful.
First and maybe most important is emotional support. We need people who are there for us and who listen to us. When loved ones empathize, comfort, or reassure us, we feel that we matter to them. We can also share what we are experiencing, which can ease stress and anxiety. Strong emotional support can also help increase the willpower needed to overcome a health challenge. (Of course, there are family and friends who are NOT helpful.)
Second, people offer us informational support. This type of support may come from doctors or support groups. You might get information about nutrition, health, or treatment. When people share information with us, we feel like we have more tools to solve our problems, such as easing side effects. These tools may also increase our feeling of control, making us more optimistic about the future and less vulnerable.
Third, friends and family can offer us practical support, such as rides to doctor’s appointments or treatments, meals, or help with household chores.
Increasingly, doctors are telling people how to make and maintain social connections, because these connections can dramatically improve health and even increase survival rates. Many of us need to learn how to ask for the support we need. This may mean going beyond your comfort zone, especially if you’re a stubbornly independent person (like me) who doesn’t want to depend on anyone else.
Social connections: What does the research show?
A review of 148 studies of all types of social relationships found that social isolation can increase the risk of dying from any cause as much as well-known risks such as smoking and drinking alcohol.
Scientists also have studied how social connections affect the risk of dying from cancer:
- A study of 735,000 Americans found that being single, separated, divorced, or widowed was linked to a 20% greater risk of earlier death from cancer. Of course, there are married people who are miserable. But in general, people who have a strong social connection such as marriage tend to be healthier. There are a number of reasons for this: people with strong social connections are more likely to be screened for cancer than those without someone to nudge them. People with strong social connections are also more likely to have healthier behaviors (not smoking, eating healthier food, etc.) because they have people who remind them to do these things. So isolated people are more likely to be diagnosed with later stages of disease than married people.
- The same study evaluated the effects of marriage on five cancers — prostate, breast, colorectal, esophageal, and head/neck cancers. Married people were more likely to survive cancer than single people with the same disease. The study compared those survival rates to the benefits of chemotherapy for the same cancers and found that the benefits of marriage were equal to or greater than the benefits of chemotherapy. Of course, this doesn’t mean that if you’re married and diagnosed with breast cancer, you can skip chemotherapy! Marriage doesn’t actually kill cancer cells. But your partner might give you critical emotional and physical support during treatment and help you handle side effects. Support like this could explain why married people have better survival.
How social connections benefit health
Still, these results don’t necessarily mean that you’re threatening your health if you’re not coupled up. Marriage isn’t for everyone. Single people can be happy and healthy, too, especially if they have a good social network of family, friends, a religious organization, clubs, or hobbies. For example, another study found that people with larger social networks, especially people with strong emotional support, had a lower risk of dying from breast cancer.
Consider one analysis of 87 studies, which found that being married improved cancer survival by 12%. And people who felt supported (whether from marriage, friends, religious groups, clubs, volunteering, or elsewhere) had 25% better survival.
So what is it about social connections that help our health? One possibility is that stress causes unhealthy changes in the body, including releasing stress hormones into the blood, causing inflammation. If the stress continues for a long time, the extra stress hormones can irritate cells and wear down the immune system. All of this may be linked to tumor growth. Social support can ease stress and may limit or stop these changes.
Regular encouragement can help us stay healthy. Social support may help someone drink less alcohol, quit smoking, or lose weight. Also, people with better social networks tend to have more help navigating the healthcare system.
But the health benefits of social networks are also about quality, not just quantity. Having a few good, close relationships can be just as effective as having more social connections. One study showed that women with small networks who received strong support from a few people got the same survival benefit after a breast cancer diagnosis as women with larger networks.
How to strengthen your social connections
Clearly it’s important to have regular social connections in your life. Even if you consider yourself shy or a bit of a loner, there are still many ways to meet new people or get closer to the people you care about.
You can broaden your social network at any time in life. Do you have a hobby? Do you like sports? Art? Nature? Dance? Cooking? Reading? Knitting? Are you interested in volunteering? For every interest there is a group — you just have to find it.
Meeting new people and trying new things can feel awkward or uncomfortable at first. If you experience that, don’t give up. Try going back a few times so you get more familiar with the other people who attend and they become more familiar with you.
Also, consider the quality of your existing relationships. Sharing joys and fears — being open about what’s really going on inside — helps us to connect with each other. Being diagnosed with cancer is scary, and both you and your loved ones may respond to that stress in different ways. You may have the urge to pull away. You might feel like people expect you to put on a brave face. Loved ones may seem distant because they don’t know what to say or how to help. Or they might be afraid of losing you.
Try to be honest and clear about what you’re feeling. Then think about what you really want or need from your spouse or best friend. Do you want someone to go with you to appointments? Do you want someone to just listen to your fears without trying to “solve” them? Do you want to be held? Ask for what you need directly. Don’t assume that anyone knows what you need. It might feel uncomfortable to ask for help. But by asking directly for what you need, you’re actually giving your family and friends a gift: a clear opportunity to support you with what you need and want most. With these strategies, the experience of dealing with cancer can actually help you grow even closer to the people you love and who love you.
But even if your loved ones are very supportive, they may not fully understand what you’re going through. Support groups, particularly ones that meet in person, can also be hugely valuable. Ask your doctor or cancer center what kind of support groups are in your area. Many have a specific focus, such as metastatic disease or parents with cancer. Talking to others sharing the same experience, feeling that you’re not alone, offers psychological relief.
There are also many online support forums and communities for days when you just can’t get out of the house. I’ll talk more about those resources in an upcoming column.