Doctor: You might have a phobia of marriage. Do you think you have the symptoms?
Man: Can’t say I do.
Doctor: Yes. That’s the main one.

It is a common stereotype that men fear commitment. The truth is, so-called commitment phobia can affect anyone, and not just over romance. Long-term jobs or career choices, friendships, even making plans can all be subject to waffling beforehand or getting out early. But let’s face it. We humans are a social species. Being in relationships supports wellness:

The benefits of social connections and good mental health are numerous. Proven links include lower rates of anxiety and depression, higher self-esteem, greater empathy, and more trusting and cooperative relationships. Strong, healthy relationships can also help to strengthen your immune system, help you recover from disease, and may even lengthen your life.^[i]

Harvard Health refers to caring involvement with others as “one of the easiest health strategies to access.” On the other hand, being deprived of social ties can have dire consequences:

One study, which examined data from more than 309,000 people, found that lack of strong relationships increased the risk of premature death from all causes by 50% — an effect on mortality risk roughly comparable to smoking up to 15 cigarettes a day, and greater than obesity and physical inactivity.^[ii]

Marriage and prostate cancer

The strong bonds that develop in a healthy committed relationship offer durable social support that boosts physical as well as emotional wellness. In fact, research suggests that men who say “I do” (and follow through) have better odds of surviving prostate cancer (PCa) if they get it. For example:

1. A study of 115,922 PCa cases found that marriage saves lives. The majority of patients were married (78%) while the remaining 22% were either never married, separated, divorced or widowed. The married men tended to have less aggressive, earlier stage disease. The unmarried men had a 40% increased probability of dying from their PCa, and higher probability of all-cause death “compared to married men of similar age, race, stage, and tumor grade.”^[iii]
2. Research with 3579 PCa patients who had prostatectomy for localized (stage 1-2) PCa demonstrated that marriage improved treatment success rates. “Not being married (vs. married) at the time of radical prostatectomy was associated with an increased risk of all cause mortality… Similarly, in analyses of marital history, never married men were at highest risk of all-cause mortality… Unmarried status (vs. married) was also associated with an increased risk of prostate cancer-specific mortality.”^[iv]
3. An international study of men with hormone-sensitive metastatic PCa revealed that, with 5 years of follow-up, unmarried and widowed patients had worse overall survival (OS) than
   married patients. “Most were married/in a civil partnership (79%) and 6% were widowed. Very few married participants were living alone (1%), while most unmarried participants were living alone (70%). Married participants had better OS than unmarried participants… Widowed participants had the worst survival compared to married individuals …”^[v]

What might explain such consistent findings? One obvious factor is the influence of wives over their husbands’ health habits. Men who might not otherwise adhere to annual exams and PSA tests are often encouraged by wives to “get thee to a doctor” on a regular basis. Thus, they would be more likely to be diagnosed with early-stage disease amenable to successful treatment. One early (1996) study which also found that married PCa patients had “significantly longer median survival than those who were divorced, single, separated or widowed” offers further insight:

Several hypothetical models can explain the association of marital status and mortality in men with prostate cancer. The most attractive model relies on the putative salutary effects of being married on social support and/or mood. A social support and depressed mood model of mortality raises the possibility that in prostate cancer quality of life determines quantity of life. Understanding the relationships among marital status, social support, mood and mortality could open the way to rational strategies for postponing death in men with prostate cancer.^[vi]

I suspect that men who are reluctant to say “I do” will not be motivated to pop the question, offer a ring, and head to the altar based on thinking that if they get prostate cancer, marriage will help them live longer. However, for readers who are already married, I hope that the above research adds one more reason to love and cherish your wife.

NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.

References

[i] “Strong relationships, strong health.” https://www.betterhealth.vic.gov.au/health/healthyliving/Strong relationships-strong-health
[ii] “The health benefits of strong relationships.” Dec. 1, 2010. https://www.health.harvard.edu/staying-healthy/the health-benefits-of-strong-relationships
[iii] Tyson MD, Andrews PE, Etzioni DA, Ferrigni RG et al. Marital status and prostate cancer outcomes. Can J Urol. 2013 Apr;20(2):6702-6.
[iv] Khan S, Nepple KG, Kibel AS, Sandhu G et al. The association of marital status and mortality among men with early-stage prostate cancer treated with radical prostatectomy: insight into post-prostatectomy survival strategies. Cancer Causes Control. 2019 Aug;30(8):871-876.
[v] Chen N, McGrath CB, Ericsson CI, Vaselkiv JB et al. Marital status, living arrangement, and survival among individuals with advanced prostate cancer in the International Registry for Men with Advanced Prostate Cancer. Cancer Epidemiol Biomarkers Prev. 2024 Jan 8.
[vi] Krongrad A, Lai H, Burke MA, Goodkin K, Lai S. Marriage and mortality in prostate cancer. J Urol. 1996 Nov;156(5):1696-70.