Suicide risk is increased among
cancer patients
People with cancer are more likely to commit suicide and hurt themselves, according to two recent studies that were published in Nature Medicine.
In one study, a meta-analysis of 28 research revealed that
the suicide rate among cancer patients was approximately twice as high as that
of the general population. The study, which involved more than 22 million
individuals, discovered that patients with poor prognoses had the highest
probability of committing suicide. Those with esophageal cancer, liver and
biliary system cancer, mesothelioma, and pancreatic cancer were most at risk.
Compared to Europe, Australia, and Asia, suicide mortality among cancer
patients was much higher in the United States. An examination of the broader
population did not reveal any disparities.
The principal author of the study and a senior physician
in the Department of Neurology at University Hospital Heidelberg in Germany,
Corinna Seliger-Behme, MD, PhD, says, "Our findings imply that doctors
should be aware of the elevated risk of suicide among patients with cancer."
"Clinicians should closely watch their patients for indications of
depression and suicidality in order to quickly refer them for specialised
psycho-oncological therapy. Patients with a poor prognosis, those with
late-stage disease, and [those] within the first year after diagnosis, in
particular in the US, should receive special attention."
The most prevalent psychiatric disorder is depression
The authors of the second article examined the medical
histories of 459,542 British citizens who were 18 years of age or older and had
received a diagnosis of one of 26 different cancer types.
The study's senior author Alvina Lai, PhD, an associate
professor at the Institute of Health Informatics at University College London,
and her coworkers discovered that personality disorders, schizophrenia, bipolar
disorders, and anxiety disorders were the other most prevalent psychiatric
disorders among cancer patients. Over 25% of the study's participants struggled
with substance misuse.
According to a research from the United Kingdom, more than
1% of cancer patients admitted to self-harming after receiving their diagnosis.
Prior to receiving a cancer diagnosis, those who had a psychiatric diagnosis
had higher rates of self-harm. The highest prevalence of self-harm was seen in
those with depression, particularly within a year of their cancer diagnosis,
among the five psychiatric diseases that were examined: depression, anxiety
disorders, schizophrenia, bipolar disorders, and personality disorders. Within
a year following self-harm, patients were 6.8 times more likely than those in
the control group to pass away from unnatural causes.
Implications
These results have a number of ramifications, in Dr. Lai's opinion, including:
The significance of discussions with patients and their
families at the point of cancer diagnosis regarding the risk of mental illness
in order to promote awareness and to encourage help-seeking behaviour; The
necessity of fostering collaborative clinical care between oncologists and
psychiatrists; The importance of early recognition and treatment of mental
illness and monitoring for self-harm.
In an editorial that accompanied both studies, Sumanta
Pal, MD, a professor in the department of medical oncology and experimental
therapeutics at City of Hope Comprehensive Cancer Center in Duarte, California,
and Cristiane Decat Bergerot, PhD, of the Centro de Câncer de Brasil, Instituto
Unity de Ensino e Pesquisa, Brasilia, Brazil, stated that the two studies
provide support for changing risk factors mentioned in current psychooncology
guidelines.
They argued that technologies that can recognise patients
who require more assistance must be developed globally. The findings of these
research may serve to guide greater treatments and screening in environments
with limited resources, they suggested. Approaching patients early in their
cancer journey and focusing particularly on cancers with greater rates of
psychological burden and/or suicide risk may be a viable strategy.
Timothy J. Moynihan, MD, an expert with the American
Society of Clinical Oncology and an emeritus medical oncologist at Mayo Clinic,
who was not involved with the research, said, "These are really
interesting and relevant studies." "There aren't any other studies
that I'm aware of that look at the connection between suicide risk and cancer
and are as substantial as these two. Although the increased risk of suicide in
cancer patients has long been known, these two studies help put that risk into
perspective and emphasise the importance of raising awareness of that risk
among all caregivers, screening for it prospectively, and assembling a team
that can facilitate early treatment to help prevent this cancer
complication."
