US study confirms cancer suicide risk

A US study published online on 7 Jan 2019 in the journal Cancer has confirmed British research published last November on the elevated risk of suicide following a diagnosis of cancer.

Divorced, white and male patients were more likely to commit suicide than married or single, non-white and female patients. The highest risk of suicide was within the first two months after diagnosis.

Co-senior author Hesham Hamoda, MD, MPH, of Harvard Medical School in Boston, told MedPage Today that “several factors involved with a cancer diagnosis may be at work, such as the adverse effects of treatment (pain, fatigue), feelings of alienation, and changes in appearance (disfiguration, loss of hair). Lung cancer patients who smoked tobacco may also contend with guilt.”

Hamoda also discussed the higher risk of suicide for divorced patients than married, widowed, separated, or single patients. “Since both single and divorced patients potentially lack the same social support as a married patient, the increased risk could be due to cumulative life stressors, as opposed to lacking a support system.”

Since the risk of suicide was highest within 2 months after diagnosis, Hamoda emphasized the importance of providing counseling or mental health services for patients diagnosed with cancer right away, as well as equipping patients with enough knowledge to learn about their disease, particularly to avoid misinterpretation when they begin searching the internet to find out more about their prognosis.

"If I had one take-home message in terms of what should be done, I would say mental health services should be embedded within oncology services, where someone with a new diagnosis can immediately and preemptively meet with someone and get emotional support," Hamoda said.

This should be a priority for oncology services in Victoria instead of embedding a suicide affirmation facilitator at Peter MacCallum. The very existence of such a person in a cancer service sends a signal to all cancer patients that suicide is a valid, normal and rational option approved by the State of Victoria.

Under Victoria’s assisted suicide law a cancer patient could be dead by ingesting a legally prescribed lethal poison within two weeks of being given a diagnosis of cancer with a prognosis that the disease is "expected to cause death within 6 months".