• Junmei Miao Jonasson, Arna Hauksdóttir, Unnur Valdimarsdóttir, Carl Johan Fürst, Erik Onelöv, and Gunnar Steineck.
• Department of Oncology-Pathology, Division of Clinical Cancer Epidemiology, Karolinska Institutet, Karolinska Hospital, Stockholm, Sweden. junmei.jonasson@oc.gu.se
• Eur. J. Cancer. 2009 Jul 1;45(10):1839-45.

AimTo investigate if a cancer patient's unrelieved symptoms during the last 3 months of life increase the risk of long-term psychological morbidity in the surviving widower.MethodsMen (n=907) younger than 80 years and living in Sweden, who had lost their wives due to cancer, were asked 4-5 years after their loss to answer an anonymous postal questionnaire that included questions about their current psychological morbidity and their wives' unrelieved symptoms during the last 3 months of life.ResultsIf the wife suffered unrelieved anxiety or pain during the last 3 months of her life, then the widowers had a higher risk of sleep-related problems 4-5 years after the loss. When the wife had suffered from anxiety, the relative risks (RR) for the widowers' sleep-related problems were: difficulty falling asleep (RR 1.7, 95% CI 1.0-3.0) and waking up at night with anxiety (RR 4.9, 95% CI 1.5-15.7). When the wife had unrelieved pain, the widowers years later had an increased risk of difficulty falling asleep at night (RR 1.8, 95% CI 1.0-3.3).ConclusionsThe unrelieved patients' end-of-life problems increase the risk of widowers' long-term mental suffering. Efficient and effective diagnoses and treatment of pain and anxiety in terminally ill cancer patients are critical for both patients and their surviving widowers.

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