Cancer patients are at an increased risk of suicide, especially shortly after diagnosis, according to a report in the October 15th issue of the Journal of Clinical Oncology.
Earlier reports indicated that suicide rates are higher in cancer patients than in the general population, the authors explain, but cancer treatment, psychosocial support, and social attitudes have changed since the most recent data were collected.Dr. Erlend Hem and colleagues from the University of Oslo used the Cancer Registry of Norway and the Register of Deaths at Statistics Norway to investigate the risk of suicide among cancer patients in the four decades from 1960 to 1999.Compared with the general population, the relative suicide risk was elevated by 55% in men and by 35% in women with a cancer diagnosis, the authors report. Still, the number of deaths by suicide was quite low compared with other causes of death.The suicide risk during the first 5 months after diagnosis was increased threefold among men and more than doubled among women, the report indicates, and declined in the ensuing months.The suicide risk declined significantly over the decades, the investigators report, with the relative risk falling from 3.54 to 2.07 among men and from 3.08 to 1.28 among women.In men, the risk was highest with cancer of respiratory organs, the researchers note, whereas women with cancers in the buccal cavity and pharynx had the highest relative risk.Men more often committed suicide by firearms, the results indicate, and women more often committed suicide by drowning. These methods were similar to those in the general population.”Frank discussion of suicidal ideation with cancer patients is important,” the authors write.”It is particularly important to evaluate the presence of hopelessness, which may be a stronger predictor of suicidal risk than depression itself.””The ability to communicate openly and clearly with their patients about these difficult issues should be a part of the physician’s toolbox,” they add.(Source: J Clin Oncol 2004;22:4209-4216: Reuters Health: Oncolink: November 2004.)