Suicides In Cancer

by Jane Ashley

Most of us who have had or who have cancer want to continue living and accept the side effects, surgical pain and financial consequences of cancer treatment. We want to live, and we’re usually willing to take dramatic steps to survive.

Cancer Types Suicide

We probably haven’t ever contemplated the fact that the suicide rate is significantly higher for cancer patients than the general population. The National Cancer Institute studied cancer patients older than 20 whose cause of death was “suicide of self-inflicted injury” in the years from 2000 to 2013. The data included sex, age at diagnosis, race, marital status, surgical and year at diagnosis. The study incorporated their type of cancer, stage, date of last follow-up, and vital status at last follow-up.

This study determined that the rate of suicide among cancer patients was almost twice as high as for the general population. They also discovered that the trends seen in the general population were mirrored in the cancer patient population.

Which cancer patients are most at risk for suicide?

Oncologists and their medical teams along with caregivers need to know who is most at risk is and how to help them. The common denominator among cancer patients who took their own lives were:
• Male
• Over 65 (highest rates for those above 80)
• Caucasian
• Diagnosed with esophageal, head & neck, liver, lung and pancreatic cancers.

In this group of patients, suicide rates held steady regardless of whether the patient was in treatment or refused treatment or whether it was a local tumor, localized regional or distant metastasis. In spite of much improved cancer treatments over the 13 years studied, the suicide rate remained essentially the same.

Overall, males make up almost 85 percent of all cancer patient suicides. Over 50 percent of the males who commit suicide are married. Only about 18 percent have Stage IV disease. So it’s not just men living alone who with metastatic disease who take their own lives.
We can’t make broad statements, but it appears that just the diagnosis of cancer pushes a vulnerable subset of cancer patients over the edge.

So what can we do?

Oncology nurses are on the front line and are in a position to detect deepening depression in this subset of patients. The clinical social worker might recognize serious depression in an older, Caucasian male patient. Caregivers for this group of cancer patients need to be alert to changes in mood and behavior (poor appetite, poor hygiene, withdrawn behavior).

Every healthcare professional in contact with this group of patients should pay attention to signs of depression, especially in the first months after diagnosis. The symptoms of depression overlap with the side effects of treatment – weight loss, fatigue, and insomnia – making it difficult to distinguish depression from side effects.

Some oncology groups use mental health questionnaires on a regular basis to help screen for patients who are experiencing major depression and other mental health issues.

Why? How can family and friends help?

Suicide is associated with depression and a feeling of hopelessness. For cancer patients, “not wanting to be a burden” is a concern too. Major untreated depression is the prime risk factor for suicide in cancer patients.

Encouragement Helps Fight Depression

Family members of the most at-risk cancer patients should be alert if they see signs of depression and/or hopelessness. Phrases like “you’d be better off without me” or “I don’t want to be a burden on anyone” are signals that your loved one may be at risk.

It’s critical that friends, neighbors, fishing buddies, golf partners and the morning coffee club buddies stay in touch and offer support. We need to let them know that we can help with transportation or meal prep. Include them in regular activities – offer to pick them up for regular morning coffee. Invite your buddy for a short fishing trip.

The impact of our aging population

About 10,000 people daily are turning 65 in the U.S. People born between 1946 and 1964 are defined as baby boomers, part of the post-World War II era. More people were born in that time frame than before or afterward.

Take Your Grandfather Fishing

Recent statistics show that the suicide rate among baby boomers has increased. Will it continue to increase as more boomers turn 65? No one knows.

Baby boomers have always had a “can do” and positive attitude . We’re more active, we work longer, and we exercise more. Let’s hope increased awareness about cancer patient suicide will create improved opportunities to prevent suicide among cancer patients.

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