GU cancer diagnoses may have adverse health impacts for patients’ family members

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“As health care professionals, we should take a multidisciplinary approach to addressing the stress of a cancer diagnosis by helping mitigate financial toxicity, treatment burden, and emotional impact on both the patient and their family," says Mouneeb M. Choudry, MD.

Family members of patients who have been diagnosed with a genitourinary (GU) cancer may have an increased risk of psychological illness and cardiovascular disease, according to data recently published in the journal Cancer.1

Family members of patients with cancer had a 28% increased risk of developing cardiovascular disease at 1 year following the patient’s diagnosis.

Family members of patients with cancer had a 28% increased risk of developing cardiovascular disease at 1 year following the patient’s diagnosis.

“A diagnosis of cancer is a life-changing event for patients and their families. With our group’s unique access to the Utah Population Database, we were able to create multi-generational networks highlighting the impact of a cancer diagnosis on families,” said lead author Mouneeb M. Choudry, MD, urology resident at Mayo Clinic in Phoenix, Arizona.2 “As health care professionals, we should take a multidisciplinary approach to addressing the stress of a cancer diagnosis by helping mitigate financial toxicity, treatment burden, and emotional impact on both the patient and their family.”

For the study, the investigators obtained data from 77,938 first-degree relatives and spouses of 49,284 patients who received a diagnosis with genitourinary cancer between 1990 and 2015 and compared them to data from 81,022 first-degree relatives and spouses of 246,775 individuals who were not diagnosed with cancer. The median age of first-degree relatives or spouses of cancer patients was 40 years, with 53.2% being female and 47.8% being male.

Based on Cox proportional hazards models, data showed that relatives of patients who received a diagnosis with cancer had a 10% increased risk of developing a psychological illness (HR, 1.10; 95% CI, 1.00–1.20; P = .043) at 1 year following the family member’s diagnosis compared with controls. At 3 and 5 years, their risk was 5% (P = .046) and 4% (P = .078) higher, respectively. In total, 7.1% of relatives and spouses of a patients with cancer were diagnosed with a psychological illness within 5 years of their family member’s diagnosis, compared with 5.9% of controls.

Additionally, family members of patients with cancer had a 28% increased risk of developing cardiovascular disease (HR, 1.28; 95% CI, 1.17–1.41; P < .001) at 1 year following the patient’s diagnosis compared with controls. At 3 and 5 years, the risk was 16% (P < .001) and 14% (P < .001) higher, respectively. In total, 7.6% of relatives of patients with cancer were diagnosed with cardiovascular illness within 5 years of the patient’s diagnosis compared with 5.4% of controls.

Data also showed that the risk of psychological illness or cardiovascular disease at 1 year following a patient’s diagnosis was nearly 4 times higher for parents with children who were diagnosed with cancer compared with other types of relationships. Living closer to the patient with cancer was also associated with worse health outcomes for relatives.

Additionally, family members of patients diagnosed with kidney and bladder cancer appeared to have the worst risk of developing psychological and cardiovascular comorbidity compared with relatives of patients with other GU cancer types. Testis cancer was shown to be the least stressful.

The authors noted that future work is still necessary.

Specifically, they wrote, “More research is needed to evaluate the impact of cancer diagnoses on a variety of racial and ethnic groups. We suspect that these findings would be similar or exacerbated, given the disparities in health outcomes currently seen among racial and ethnic groups in the United States.”1

They also note that future work could further assess the health impacts of specific cancer types on family members.

Overall, they conclude, “This study provides population-level evidence to support the hypothesis that cancer diagnoses will lead to adverse health outcomes for family members of patients with cancer. Increased clinical attention and support are needed to reduce the harm to families caused by cancer.”1

References

1. Choudry MM, Murray N, Dindinger-Hill K, et al. Genitourinary cancer and family: The reverberating psychological and cardiovascular effects of a genitourinary cancer diagnosis on first-degree relatives and spouses. Cancer. 2024. doi:10.1002/cncr.35486

2. Can coping with a cancer diagnosis contribute to psychological and cardiovascular problems in family members? News release. WILEY. September 9, 2024. Accessed September 12, 2024. https://www.eurekalert.org/news-releases/1056627

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