Cancer Advances: Suicide Risk among People with Cancer

Posted online August 11, 2008, on www.jco.org.

Three new studies being published in the Journal of Clinical Oncology (JCO) describe concerning trends suggesting that patients with cancer are more likely to commit suicide or to contemplate taking their own lives, compared with the general population.

Suicide is twice as common among people with cancer and survivors, compared with the general United States population

• One study found that the rate of suicide among people with cancer was nearly twice that of the general U.S. population (31.4 per 100,000 person-years for patients with cancer, versus 16.7 per 100,000 person-years in the general population) from 1973 to 2002. The highest suicide risks were observed in patients with lung, stomach, head and neck cancers. The risk of suicide was greatest within the first five years of cancer diagnosis but remained elevated up to 15 years following diagnosis.
• A second study found that among people 65 and older, suicide risk was 2.3 times greater among people with cancer than among those without cancer—even after adjusting for age, sex, race, medical and psychiatric illnesses (which are more common among older Americans) and use of prescription medications. Patients with cancer who committed suicide were more likely to have metastatic disease. Most had visited a physician in the month before their death, and 25 percent were seen within a week of their suicide.

People with cancer are more likely to have suicidal thoughts

The third study examined whether patients reported thoughts of being “better off dead” or of “hurting themselves in some way” in the previous two weeks before visiting an outpatient clinic. Nearly 8 percent of participants said such thoughts persisted over at least several days during this period. The authors found that suicidal thoughts were associated with having substantial emotional distress or pain and not with cancer severity. They concluded that awareness and communication about these symptoms can improve patients' quality of life and may also reduce suicide risk.

What This Means for Patients

These studies are a powerful reminder that cancer patients and survivors who experience pain, depression, emotional distress or suicidal thoughts are at somewhat higher risk for taking their own lives. It is important that warning signs and risk factors are identified as soon as possible, so that physicians, family members and friends can intervene and provide counseling and other treatment that can minimize suicide risk.

If, as a person with cancer, you feel depressed, overwhelmed, or hopeless, you should speak with your doctor or another member of the health care team. If you are contemplating ending your own life, please seek help immediately.

Helpful Links:

• Depression and anxiety
• Talking with someone who has cancer
• Telephone and Email Cancer Helplines