Assessing structure and characteristics of social networks among cancer survivors: impact on general health

  • Nicolette Payne
  • Elizabeth Palmer Kelly
  • Timothy M. PawlikEmail author
Original Article



Robust social networks are associated with improved health and quality of life for cancer survivors. Certain cancer diagnoses are associated with higher levels of stigma than breast cancer. However, little is known about the differences in social networks depending on the type of malignancy. This study aims to assess the differences in social networks and general health between breast cancer and more stigmatized cancers.


Cancer survivors were recruited to participate in a cross-sectional online survey study. Social network size and satisfaction was measured using the Cancer Survivor Social Networks Measure. General health was measured with a five-point-Likert-style item.


The average age of the sample (n = 99) was 57.6 years old (SD = 13.4) and the majority were female (67.7%). Breast cancer survivors had an average of 1.39 more members in their social network than other cancers (t(94) = 2.28, p = 0.025). There were no significant differences between groups in network satisfaction. Results of a binary logistic regression model explained 26.9% of the variance in general health (x2(5) = 18.35, p = 0.003). There was a significant association among formal support network satisfaction (β = − 1.23, p = 0.021), formal support network size (β = − 0.36, p = 0.019), malignancy type (breast vs. other) (β = 1.05, p = 0.05), and better general health.


The results suggest breast cancer survivors had more formal social supports then other malignancy types. An association among greater formal social network size and satisfaction, a diagnosis of breast instead of other cancers, and better general health was noted. Emphasizing formal support sources for all cancer survivors may improve their overall health.


Social network size Social network satisfaction Social support General health Stigma 


Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflicts of interest.


  1. 1.
    Miller KD, Siegel RL, Lin CC, Mariotto AB, Kramer JL, Rowland JH, Stein KD, Alteri R, Jemal A (2016) Cancer treatment and survivorship statistics, 2016. CA Cancer J Clin 66:271–289. CrossRefPubMedGoogle Scholar
  2. 2.
    Lim J, Zebrack B (2006) Social networks and quality of life for long-term survivors of leukemia and lymphoma. Support Care Cancer 14:185–192. CrossRefPubMedGoogle Scholar
  3. 3.
    Pinquart M, Duberstein PR (2010) Associations of social networks with cancer mortality: a meta-analysis. Crit Rev Oncol Hematol.
  4. 4.
    Kim BH, Wallington SF, Makambi KH, Adams-Campbell LL (2015) Social networks and physical activity behaviors among cancer survivors: data from the 2005 health information national trends survey. J Health Commun 20:656–662CrossRefGoogle Scholar
  5. 5.
    Kroenke CH, Kubzansky LD, Schernhammer ES, Holmes MD, Kawachi I (2006) Social networks, social support, and survival after breast cancer diagnosis. J Clin Oncol 24:1105–1111. CrossRefPubMedGoogle Scholar
  6. 6.
    Flanagan J, Holmes S (2000) Social perceptions of cancer and their impacts: implications for nursing practice arising from the literature. J Adv Nurs 32:740–749. CrossRefPubMedGoogle Scholar
  7. 7.
    Fife BL, Wright ER (2000) The dimensionality of stigma: a comparison of its impact on the self of persons with HIV/AIDS and cancer. J Health Soc Behav 41:50–67CrossRefGoogle Scholar
  8. 8.
    Koller M, Kussman J, Lorenz W, Jenkins M, Voss M, Arens E, Richter E, Rothmund M (1996) Symptom reporting in cancer patients: the role of negative affect and experienced social stigma. Cancer: Interdisciplinary International Journal of the American Cancer Society 77(5)983–995Google Scholar
  9. 9.
    LoConte NK, Else-Quest NM, Eickhoff J et al (2008) Assessment of guilt and shame in patients with non-small-cell lung cancer compared with patients with breast and prostate cancer. Clin Lung Cancer 9:171–178. CrossRefPubMedGoogle Scholar
  10. 10.
    Chapple A, Ziebland S, McPherson A (2004) Stigma, shame, and blame experienced by patients with lung cancer: qualitative study. BMJ 328:1470. CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Lebel S, Devins GM (2008) Stigma in cancer patients whose behavior may have contributed to their disease. Future Oncol 4(5):717–733CrossRefGoogle Scholar
  12. 12.
    Jefferies H, Clifford C (2011) Aloneness: the lived experience of women with cancer of the vulva. Eur J Cancer Care (Engl). 20:738–746. CrossRefGoogle Scholar
  13. 13.
    Bullen K, Edwards S, Marke V, Matthews S (2010) Looking past the obvious: experiences of altered masculinity in penile cancer. Psychooncology 19:933–940. CrossRefPubMedGoogle Scholar
  14. 14.
    Philp S, Mellon A, Barnett C, D'Abrew N, White K (2017) The road less travelled: Australian women’s experiences with vulval cancer. Eur J Cancer Care (Engl) 26.
  15. 15.
    Knapp-Oliver S, Moyer A (2012) Causal attributions predict willingness to support the allocation of funding to lung cancer treatment programs. J Appl Soc Psychol 42:2368–2385. CrossRefGoogle Scholar
  16. 16.
    National Breast Cancer Foundation National Breast Cancer Foundation. Accessed 1 June 2018
  17. 17.
    ResearchMatch. Version 2018. Vanderbilt UniversityGoogle Scholar
  18. 18.
    Cancer Survivor Social Networks Measure | Cancer Surveillance and Outcomes Research Team. Accessed 28 Nov 2018
  19. 19.
    Qualtrics Labs, Inc [computer program]. Version June 2018. Provo, Utah, USA. 2009Google Scholar
  20. 20.
    IBM Corp. Released 2017. IBM SPSS statistics for Macintosh, version 25.0. IBM Corp, ArmonkGoogle Scholar
  21. 21.
    Berkman LF (1995) The role of social relations in health promotion. Psychosom Med 57:245–254. CrossRefPubMedGoogle Scholar
  22. 22.
    House JS, Landis KR, Umberson D (1988) Social relationships and health. Science 59:676–684. CrossRefGoogle Scholar
  23. 23.
    Uchino BN, Cacioppo JT, Kiecolt-Glaser JK (1996) The relationship between social support and physiological processes: a review with emphasis on underlying mechanisms and implications for health. Psychol Bull 119:488–531. CrossRefPubMedGoogle Scholar
  24. 24.
    Ell K, Nishimoto R, Mediansky L, Mantell J, Hamovitch M (1992) Social relations, social support and survival among patients with cancer. J Psychosom Res 36:531–541. CrossRefPubMedGoogle Scholar
  25. 25.
    Spiegel D, Bloom JR, Kraemer HC, Gottheil E (1989) Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet.
  26. 26.
    Kuchler T, Henne-Bruns D, Rappat S et al (1999) Impact of psychotherapeutic support on gastrointestinal cancer patients undergoing surgery: survival results of a trial. Hepatogastroenterology 46(25):322–335PubMedGoogle Scholar
  27. 27.
    Satariano WA, Haight TJ, Tager IB (2002) Living arrangements and participation in leisure-time physical activities in an older population. J Aging Health 14:427–451. CrossRefPubMedGoogle Scholar
  28. 28.
    Michael YL, Kawachi I, Berkman LF, Holmes MD, Colditz GA (2000) The persistent impact of breast carcinoma on functional health status: prospective evidence from the nurses’ health study. Cancer 89:2176–2186.<2176::AID-CNCR5>3.0.CO;2-6 CrossRefPubMedGoogle Scholar
  29. 29.
    Ganz PA, Coscarelli Schagi CA, Cheng HL (1990) Assessing the quality of life-a study in newly-diagnosed breast cancer patients. J Clin Epidemiol 43:75–86. CrossRefPubMedGoogle Scholar
  30. 30.
    Reynolds P, Kaplan G a (1990) Social connections and risk for cancer: prospective evidence from the Alameda County study. Behav Med 16:101–110. CrossRefPubMedGoogle Scholar
  31. 31.
    Zhu K, Hunter S, Bernard LJ et al (2000) Mammography screening in single older African-American women: a study of related factors. Ethn DisGoogle Scholar
  32. 32.
    Kang SH, Bloom JR (1993) Social support and cancer screening among older black Americans. J Natl Cancer Inst 85:737–742CrossRefGoogle Scholar
  33. 33.
    Kang SH, Bloom JR, Romano PS (1994) Cancer screening among African-American women: their use of tests and social support. Am J Public Health 84:101–103. CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Gravell J, Zapka JG, Mamon JA (1985) Impact of breast self-examination planned educational messages on social network communications: an exploratory study. Health Educ Behav 12:51–64. CrossRefGoogle Scholar
  35. 35.
    Eng E (1993) The save our sisters project. A social network strategy for reaching rural black women. Cancer 72:1071–1077.<1071::AID-CNCR2820721322>3.0.CO;2-V CrossRefPubMedGoogle Scholar
  36. 36.
    Bell K (2014) The breast-cancer-ization of cancer survivorship: implications for experiences of the disease. Soc Sci Med 110:56–63. CrossRefPubMedGoogle Scholar
  37. 37.
    Vaux A, Harrison D (1985) Support network characteristics associated with support satisfaction and perceived support. Am J Community Psychol 13:245–265. CrossRefGoogle Scholar
  38. 38.
    Sharf BF (1997) Communicating breast cancer on-line: support and empowerment on the Internet. Women Health 26:65–84. CrossRefPubMedGoogle Scholar
  39. 39.
    Eakin EG, Strycker L a (2001) Awareness and barriers to use of cancer support and information resources by HMO patients with breast, prostate, or colon cancer: patient and provider perspectives. Psychooncology 10:103–113. CrossRefPubMedGoogle Scholar
  40. 40.
    Guidry JJ, Aday LA, Zhang D, Winn RJ (1997) The role of informal and formal social support networks for patients with cancer. Cancer PractGoogle Scholar
  41. 41.
    Langer SL, Brown JD, Syrjala KL (2009) Intrapersonal and interpersonal consequences of protective buffering among cancer patients and caregivers. Cancer 115:4311–4325. CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Manne SL, Norton TR, Ostroff JS, Winkel G, Fox K, Grana G (2007) Protective buffering and psychological distress among couples coping with breast cancer: the moderating role of relationship satisfaction. J Fam Psychol 21:380–388. CrossRefPubMedGoogle Scholar
  43. 43.
    Decker CL (2007) Social support and adolescent cancer survivors: a review of the literature. Psychooncology 16:1–11CrossRefGoogle Scholar
  44. 44.
    Hassan E (2005) Recall bias can be a threat to retrospective and prospective research designs. Internet J Epidemiol 3:1–11. CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.The Ohio State University College of MedicineColumbusUSA
  2. 2.The Ohio State University Comprehensive Cancer CenterColumbusUSA
  3. 3.Department of SurgeryThe Ohio State University, Wexner Medical CenterColumbusUSA

Personalised recommendations