Cancer patients have a two to 2-1/2 times greater risk of committing suicide than the general population, and doctors and nurses should take heed of the risk, a study by a Canadian oncologist said Wednesday.
The study was done by Dr. Wayne Kendal, a radiation oncologist at the Ottawa Hospital Regional Cancer Centre, based on an analysis of 1.3 million cancer cases in the United States. His analysis showed that 19 out of every 1,000 males with cancer and four out of every 1,000 females with cancer take their own lives.
That equates to around 24 suicides per 100,000 cancer patients per year. The general American population, including the cancer population, has a much lower rate of 10.6 suicides per 100,000 people per year, Kendal said.
"I wanted to raise awareness among caregivers who are looking after cancer patients ... for the risk of suicide in all cancer patients," he said. "I have had patients who I believe have committed suicide and I really wasn't astute to picking it up."
The study, published in the Annals of Oncology, found that gender, prognosis, stage of the disease, type of cancer, ethnicity and family situation all play a role in suicide risk.
"If we were to draw a composite picture of the patient most at risk, this would be a widowed white male, with a new diagnosis of possibly head and neck cancer or multiple myeloma, with widespread and perhaps high-grade disease or maybe a history of other cancers," he said.
"By contrast, a patient with decreased risk of suicide would be a woman of African-American heritage, with perhaps colorectal or cervical cancer, and living with her spouse."
Kendal said that male cancer patients are at nearly five times greater risk of suicide than female patients — 1,307 men to 265 women in his study. That falls in line with the male-female suicide ratio for the general population.
Overall, cancers of the lungs and bronchus, bladder, head and neck, esophagus and myeloma all rated a higher suicide risk.
Both sexes were more likely to commit suicide if their cancer had already spread, Kendal found, but men were more likely to take their own lives immediately after diagnosis.
Kendal said his study was unable to distinguish why patients killed themselves, whether because of depression, fear of pain, to exercise the right to die with dignity, or desire not to be a burden to others.
"What we as oncologists need to do, we need to realize that people need support. Oncology patients are not an island. We need to make sure that everybody has support. It's not just treating diseases, it's treating the person — the holistic approach that I wanted to foster," he said.