Dr. Corinna Seliger-Behme met a man with bladder cancer while she was training in neurology. Before the diagnosis, the man had a stable family and job, and no history of mental health problems. He tried to kill himself with a knife in the bathtub after learning of his terminal disease. He died in the psychiatric ward.
The psychological distress brought on by cancer is significant for many patients. Two studies published on Monday quantify the psychological burden of cancer in detail, using larger data sets than previous research. The findings make a compelling case for oncologists to discuss mental health issues with their patients.
If we talk about it, we can probably prevent suicide, according to Dr. Seliger-Behme, a neurologist at the University of Regensburg in Germany.
In one of the new reports, she and several colleagues reviewed 28 studies that included more than 22 million cancer patients across the world. The suicide rate for people with cancer was 85 percent higher than the general population. Cancers with the best prognoses had the lowest suicide rates, while those with the worst had the highest.
The study found that suicide rates among people with cancer were higher in the United States than in Europe, Asia or Australia. The high cost of health care in the United States may have led some patients to forgo treatment to avoid bankrupting their families, according to the authors. They wondered if easier access to firearms in the United States could have contributed to the higher suicide rates.
In the second new study, a University College London student and her colleague created a large database from the health records of about 460,000 people with 26 different cancer diagnoses.
Five percent of patients were diagnosed with depression after their cancer diagnoses, and the same was true for anxiety. Some of the group self- harmed after their diagnoses. Brain tumors, Hodgkin's lymphoma, testicular cancer, and melanoma were the most common types of cancer that people hurt themselves with.
The study found that 25% of the cancer patients had substance abuse disorder. Substance abuse tended to increase over time even after a diagnosis.
Treatment involving surgery, radiation, and chemotherapy was the single biggest risk factor for developing a mental health condition according to the analysis. The long, intense and cumulative side effects of this triple-threat approach to cancer treatment could explain why it causes depression, anxiety and even personality disorders in many people.
Targeted drugs that have fewer side effects had the lowest rates.
It would be useful for cancer patients who are newly diagnosed to see the data to make an informed decision.
The study yielded some surprising findings. testicular cancer has a higher risk of depression than any other cancer type, affecting 98 of every 100 patients.
The chair of the psychiatry department at M.D. Anderson Cancer Center said that it is one of the better progess forms of cancer. He said that the finding underscores how tumultuous a diagnosis can be.
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Wendy Balliet, a clinical psychologist at the Hollings Cancer Center at the Medical University of South Carolina in Charleston, said that studies assessing mental health are typically based on questionnaires that rely on self-reporting. People may not be forthcoming about their mental health issues because of the stigma. She noted that the complexity of declaring a death a suicide may lead to under reporting of the connection between cancer and self-destructive behavior.
The results raise questions about how much more counseling and support patients could get.
Cancer patients with previously diagnosed mental disorders are also drawn to the studies. Patients with these conditions die from cancer at a higher rate than those without them. The study found that cancer patients with schizophrenia were more likely to receive palliative care, which may indicate that they didn't get the treatment they needed early on in their diagnoses.
It's estimated that cancer is an expensive disease and that people with severe mental disorders don't have access to care.
Current treatment guidelines suggest screening for depression as part of routine cancer care.
She said that changing mental health treatment as an integral component of your overall cancer care may go a long way.
If you're having thoughts of suicide, you can call the National Suicide Prevention Hotline or go to SpeakingOfSuicide.com.
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