The relationship between attachment insecurity at the time of surgery for sarcoma and oncologic outcome

Social support is a psychosocial variable with demonstrated significant effect on mortality, both in general and in the context of illness. A diagnosis of cancer is often the most significant event in a person’s life, and social relationships at the time of diagnosis can potentially influence their experience of illness and even survival. Sarcoma is a rare cancer that affects individuals of all ages but, in contrast to many other cancers, is independent of environmental exposures such as alcohol, tobacco or diet. In the majority of cases, there is no known cause for the sarcoma – rarely, prior history of radiation or genetic predisposition may be documented. In a review of the CDC data base, however, sarcoma was identified as a malignancy in which marital status had a significant correlation with outcome. One way to understand the link between marital status and mortality is that there may be a third factor which pre-exists both adult relationships and the factors that contribute to excessive mortality, and that influences both. One candidate for this factor is “attachment style” (AS), which refers to a person’s ‘default’ attitudes and strategies for relating to others, encompassing such interpersonal qualities as confidence in self and trust in others. It is developed early in life, and has a substantial continuity over time in most individuals. In addition to demonstrated impact on healthcare worker-patient communication, AS has also been shown to be correlated with aspects of stress physiology which could reasonably be understood to be relevant for disease progression. These 2 qualities of AS: its relevance for stress physiology and for interpersonal relationships, makes AS a promising candidate for understanding the correlation between marital status and outcome in cancer.