Suicide after a Cancer Diagnosis: Missing the Warning Signs
/A study found that after a cancer diagnosis, suicide rates more than double.
The Status Quo
If you’re a healthcare provider like me, you’ve gotten that phone call dozens of times. A friend, a co-worker, a parent has just been diagnosed with cancer. Personally, when I get that call I go into full data-gathering mode. Where is it? How big is it? Is it invasive? Is surgery an option? What did the oncologist say?
We see this forest of branching paths – various treatments, side-effects, outcomes. Some of those paths end in remission, some in full recovery, and there are some darker paths as well.
But rarely, if ever, do we consider that some of these paths will end in suicide.
Nevertheless, we now have the largest study ever published on the subject appearing in the journal Cancer.
The Study
Researchers used the SEER database – a registry of more than 4.5 million American individuals with cancer. Recorded in that data are the precise nature of the malignancy, treatments, and outcomes. Some of those outcomes are deaths, and some of those deaths are due to suicide.
1,585 of those 4.5 million individuals took their own lives within a year of their diagnosis – that’s roughly 1 out of every 625 people with cancer. This may not seem high, but that is about 2.5 times higher than the suicide rate in the general population.
A Deeper Dive
The data is granular enough to reveal some important patterns.
Deaths happen early. This is not the end of a long fight.
First. The risk of suicide was higher in the first six months after the diagnosis, compared to later on.
These are not people who have slogged through months of failed therapy. Rather, this suggests that the acute stress of the diagnosis itself is the critical factor here.
People with metastatic disease are at particular risk
Further bolstering that argument: individuals diagnosed with metastatic disease were substantially more likely to die by suicide within the year than those with local disease, though the latter group was still at a higher risk than the general population.
Finally, cancers with a historically poor prognosis (like lung and pancreatic cancer) were also associated with higher suicide rates. In fact, the suicide rate for newly diagnosed pancreatic cancer peaks at more than 16-fold the general population within 2 months of diagnosis.
Final Thoughts
Pancreatic cancer was linked to the highest rates of suicide, more than 16-fold the general population.
What do we do with this information? I think the real take-home here is that when a person has a new cancer diagnosis we need to resist that tendency we have as providers to jump straight to the plan – to try to find a way to fix the problem. And even before we start talking about all the new therapies and options and the promise of the future, we need to stop and ask simply – are you ok? And then really listen to the answer.
If you or someone you know is thinking about suicide, call the Suicide Prevention Lifeline at 1-800-273-TALK.
This commentary originally appeared on medscape.com.