Cancer patients at high risk of depression and suicide, studies show

One day, years ago, during her neurology training, Dr. Corinna Seliger-Behme encountered a man with terminal bladder cancer. Prior to t...

One day, years ago, during her neurology training, Dr. Corinna Seliger-Behme encountered a man with terminal bladder cancer. Prior to the diagnosis, the man had a stable family and job, and no history of mental health issues, Dr. Seliger-Behme recalled. But, shortly after learning of his terminal illness, he attempted suicide with a knife in the bathtub. He spent the last week of his life in the psychiatric ward.

This patient’s situation was extreme, but the psychological distress caused by cancer is significant for many patients. Two studies published on Monday quantify the psychological burden of cancer in detail, using much larger datasets than previous research. The findings make a compelling case for oncologists to have more conversations with their patients about mental health issues.

“We can probably prevent suicide if we talk about it and start really early,” said Dr Seliger-Behme, a neurologist at the University of Heidelberg in Germany.

In one of the new reports, she and several colleagues reviewed 28 studies involving more than 22 million cancers. the patients worldwide. Their analysis showed that the suicide rate was 85% higher in people with cancer than in the general population. As expected, cancers with the best prognoses – including prostate, non-metastatic melanoma and testicular cancers – had the lowest suicide rates, while those with the worst prognoses, such as cancers stomach and pancreas, had the highest suicide rates.

According to the study, suicide rates among people with cancer were significantly higher in the United States than in Europe, Asia or Australia. The authors speculate that the high cost of health care in the United States may have caused some patients to forgo treatment to avoid family bankruptcy. They also questioned whether easier access to firearms in the United States compared to countries in other parts of the world might have contributed to higher suicide rates.

In the second new study, Alvina Lai, who studies computer science at University College London, and a colleague created a large database, gleaned from the health records of around 460,000 people with 26 different cancers. who were diagnosed between 1998 and 2020 in Britain.

Five percent of patients were diagnosed with depression after their cancer diagnosis, and the same was true for anxiety. About one percent of the group had self-harmed after their diagnosis. Patients with brain tumours, prostate cancer, Hodgkin’s lymphoma, testicular cancer and melanoma were most likely to be injured.

About a quarter of cancer patients suffered from substance abuse disorders, according to the study. And psychiatric problems, including substance abuse, tended to increase over time, even years after a diagnosis.

The analysis showed that the biggest risk factor for developing a mental health problem was treatment involving surgery, radiotherapy and chemotherapy. The duration, intensity, and cumulative side effects of this triple-threat approach to cancer treatment may explain why it triggers depression, anxiety, and even personality disorders in many people.

Chemotherapy alone was also linked to high rates of psychiatric disorders, while ‘kinase inhibitors’ – targeted drugs that often have fewer side effects – had the lowest rates.

The stark data has Dr. Lai wondering if patients have enough opportunity to weigh the psychological risks of potential treatments. “It would be so helpful for newly diagnosed cancer patients to see what the data is telling us and make an informed decision,” Dr. Lai said.

The study also yielded surprising results. For example, testicular cancer carried a higher risk of depression than any other type of cancer, affecting 98 out of 100 patients.

“It’s a bit counterintuitive – it’s one of the most prognostic forms of cancer,” said Dr. Alan Valentine, chair of the department of psychiatry at MD Anderson Cancer Center in Houston, who did not participated in the study. The finding, he said, underscores how tumultuous a diagnosis can be even when a tumor isn’t life-shortening.

Because studies assessing mental health are typically based on questionnaires that rely on self-report, the data likely underrepresents reality, noted Wendy Balliet, a clinical psychologist at Carolina Medical University’s Hollings Cancer Center. South to Charleston. The lingering stigma against psychiatric disorders means people may not talk openly about their internal struggles, Dr Balliet said. She also noted that the complexities of reporting a death as a completed suicide can also lead to under-reporting of the link between cancer and fatal self-harm.

The findings raise questions about how much additional guidance and support patients might receive along the way. “It’s hard for me not to think about the conversations these patients have with their oncologists,” Dr. Balliet said.

The studies also draw attention to cancer patients with previously diagnosed psychiatric disorders, such as schizophrenia. Previous research has shown that these patients die of cancer at higher rates than those without these conditions. Dr. Lai’s study found that cancer patients with schizophrenia were more likely to receive palliative care, which could indicate that they did not receive the treatment they needed when first diagnosed.

“Cancer is an expensive disease,” said Dr. Valentine of MD Anderson, “and you could argue that people with serious mental disorders don’t have access to care or are in a health care system that doesn’t don’t have the resources they need. need.”

Current treatment guidelines suggest screening for depression as part of routine cancer care, noted Dr. Nathalie Moise, professor of medicine at Columbia University’s Vagelos College of Physicians and Surgeons. “I think these findings may support the need to also screen for suicide and other risk factors,” she said.

“Normalizing mental health treatment as an integral part of your overall cancer care can also go a long way,” she said.

If you are having suicidal thoughts, call the National Suicide Prevention Lifeline at 800-273-8255 (TALK) or go to for a list of additional resources.

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Newsrust - US Top News: Cancer patients at high risk of depression and suicide, studies show
Cancer patients at high risk of depression and suicide, studies show
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