What Shannen Doherty’s death reveals about cancer and divorce
Key Takeaways
Beloved TV star Shannen Doherty passed away at the age of 54 on July 13, 2024, after battling stage IV metastatic breast cancer for several years.
Doherty's experience highlights how a cancer diagnosis can strain marriages. Research shows mixed results on whether cancer increases the risk of divorce, but some studies indicate that women are more likely to remain in a marriage when their husband is diagnosed with cancer compared with the other way around.
Physicians can counsel patients experiencing relationship problems during cancer treatment by maintaining open communication, encouraging support, and following up with positive developments.
For legions of Gen X fans, Shannen Doherty was beloved for playing Brenda in the 1990s TV hit Beverly Hills, 90210. What many didn’t realize is that Doherty’s offscreen life was just as dramatic. She faced a number of personal setbacks, including getting fired from her breakthrough role and going through litigation, divorce, and terminal cancer.
After a years-long battle with her cancer, Doherty died on July 13, 2024, at the age of 54.
Doherty’s death raises questions for the medical community about cancer’s far-reaching toll. The fact that she was going through a divorce at the time of her death highlights the ways a cancer diagnosis can affect a marriage, in particular. It's important for physicians to be aware of how they can offer necessary support to their patients struggling with cancer or other terminal illness.
The timeline
According to media accounts, Doherty was first diagnosed with breast cancer in February 2015, and she underwent a mastectomy soon after.[][] By August 2016, she was receiving chemotherapy and radiation after surgeons noticed that the cancer had spread past her lymph nodes. She was in remission by April 2017 and underwent reconstructive surgery a year later. In February 2020, Doherty experienced a recurrence, and was diagnosed with stage IV metastatic breast cancer.
Doherty married celebrity photographer Kurt Iswarienko in 2011; the pair filed for divorce in April 2023. Doherty's well-being post-diagnosis was likely impacted by the stress of attempting to secure spousal support from her soon-to-be ex-husband (their divorce was finalized on the day before Doherty's death).[]
Doherty claimed Iswarienko was intentionally withholding financial documents to prolong the proceedings and avoid payment.[] Other pressures include losing health insurance through the Screen Actors Guild because she wasn’t able to act amid her diagnosis, and dwindling TV residuals.
Stage IV breast cancer stats
According to the SEER database for breast cancer stages—classified as localized, regional, or distant—the 5-year survival rate for distant breast cancer is 31%.[]
The SEER “distant” stage refers to cancers that have spread to parts of the body remote from the primary tumor. In February 2015, Doherty described her diagnosis as "invasive breast cancer metastatic to at least one lymph node.”[]
There are many more factors that can affect breast cancer survival rates, including tumor grade, the presence of hormone receptors on cancer cells, HER2 status, and others. Triple-negative breast cancer and inflammatory breast cancer also have their own specific survival rates.[] Besides Doherty’s having stage IV breast cancer, we know little of the details of her diagnosis. Of note, she lived for 9 years after sharing her diagnosis in 2015.
Cancer and divorce
A cancer diagnosis puts stress on a marriage—research shows that distress in the relationship arises within a year of a cancer diagnosis. Some people who get divorced are at higher risk of death but, ultimately, the long-term effects on cancer are unclear, according to authors of a systematic review published in Frontiers in Psychology.[]
“It is uncertain if there are detrimental effects on the quality of the relationship that can lead to a divorce due to a failure to cope,” they wrote. “The literature is inconsistent in this regard: on the one hand, some studies report no higher risk of divorce after a cancer diagnosis of one spouse. On the other hand, some studies provide evidence of a higher risk of divorce after a cancer diagnosis.”[]
The authors found that after a cancer diagnosis, there is a slightly decreased risk of divorce. The exception is with cervical cancer, where the risk increased. With regard to cervical cancer, the authors suggest that divorce rates could be higher because of issues with infertility and sexual changes that occur after surgery.
The authors noted that in some couples, a cancer diagnosis brings out positive coping mechanisms that support or improve the union. In others, negative coping behavior manifests, such as hiding worries. Over time, marriages can break secondary to negative coping mechanisms.
Other research has shown that the chance of divorce or a separation is six times higher for women vs men following a female vs male diagnosis of cancer.[] In other words, a woman is much more likely to stay in the marriage if their husband is diagnosed with cancer.
Well-being post-diagnosis
US researchers conducting a secondary data analysis of 505 participants in the Survivorship Survey found that certain groups of cancer survivors experience more disturbance to their social well-being than others.[] These groups include women, young adults, minorities, and those with less money. Factors that can affect well-being include time elapsed since the diagnosis, treatment status, and institutional setting. The fact that social well-being could be moderated by the healthcare institution was an interesting observation.
“Specifically, our findings indicate that there may be settings not fully equipped to provide models of care encompassing the psychosocial needs of patients, which can ultimately affect their social relationships,” the investigators stated.[]
Accordingly, they stressed the need to enhance the HCP’s capacity to address the patient’s psychosocial issues related to the relationship with partners, family members, and society at large.
“At the same time, this contribution unveiled the necessity to develop interventions able to sustain the quality of survivors’ interpersonal relationships and overall social well-being, with a particular emphasis on the experience of certain groups and for the differential burden that accompanies active treatment, early vs long-term survivorship,” they concluded.
What physicians can do
Because family physicians may know quite a bit about their patient’s lives and social environments, and have developed a rapport with them, they may be in a unique position to guide their patients on relationship problems. Moreover, patients often look to their physicians with hopes of improving themselves.
An article in Canadian Family Physician proposes a three-step counseling process to help couples with their interpersonal relationships.[]
Understanding: Ask how each patient has fared during the phases of their life in terms of dependence, independence, and interdependence. Also ask about physical, psychological, social, and spiritual development. These answers will not only help the patient better understand themselves but help you to build further rapport and trust.
Complementing: Help the couple explore how they complement each other, or don’t, in the relationship. Encourage them to work as a team. You can help the couple develop common goals that unite them. It’s important, though, not to take sides and to remain balanced.
Promising to follow up: The final stage is to follow up on the couple’s progress. The emphasis should be on the positive.
“Using a solution-focused approach, physicians can encourage and guide couples along the right path and help them not to be discouraged by minor setbacks,” the author wrote.
It should be noted that divorce is not always a “bad thing.” For some, it may be part of life’s trajectory, and a relief from the negative effects of a stressful relationship, which may be overwhelming.[]
What this means for you
As Shannon Doherty’s case illustrates, cancer can sometimes lead to the end of a patient’s marriage as well as their previous good health. Physicians may want to inquire about the effect of a cancer diagnosis and treatment on their patients’ social well-being, and offer relationship counseling when they can. If more in-depth resources are warranted, it’s always a good idea to refer patients to marriage or other counseling.