Suicide Among Lung Cancer Patients

Hannah Nichols has written a surprise article on the elevated risk of suicide among lung cancer patients.  New research was presented at the American Thoracic Society’s 2017 international conference regarding this elevated suicide risk.

The American Cancer Society reports that excluding skin cancer, lung cancer is the second most common form of cancer in the U.S. today, and the leading cause of cancer-associated death for both men and women alike.

With lung cancer the symptoms are not often noticed until it has spread throughout the lungs or to other parts of the body.  Because of a lack of symptoms in early stages, the outlook for this type of cancer is not as good as with other types.  The survival rates for those with lung cancer vary widely and depend on how early the condition is diagnosed, how far it has spread and the general health at the time of diagnosis for the person.  A significant difference to survival rates is with an early diagnosis.

It has also been shown through previous research that the social and psychological distresses connected with a cancer diagnosis can lead to an increase in suicides, compared with the general population.  A new study explored suicide rates specifically associated with lung cancer compared with the general population and with the three most common non-skin types of cancer such as breast, prostate and colorectal.

A post-doctoral cardiothoracic research fellow at Weill Cornell Medical College and New York-Presbyterian Hospital, both in New York, Mohamed Rahouma, led the research.  He and his fellow investigators used a national database called the Surveillance Epidemiology and End Results Program of the National Cancer Institute to analyze the cancer associated suicide deaths.  This type of death was evaluated among 3,640,229 patients in the database for all cancer types as well as individually for lung, breast, prostate and colorectal cancers.

There were 6,661 cancer diagnosis-related suicides over a period of 40 years.  They found the suicide rates with a cancer were 60% higher than the general population and breast cancer and prostate cancer suicide rates were 20% greater.  There was an increased risk of 40% among colorectal cancer patients.  Elevated rates of suicide were seen in people with lung cancer being 420% higher than the general population.  Asian patients were identified as having a more than 13-fold rise in suicides, and male patients had an almost nine-fold increase.

Other factors were the widowed, being older, rejecting surgical treatment for the condition and having a type of lung cancer that is difficult to treat.  Most clinicians don’t think about suicide risk in cancer patients and they should be more aware of those at greatest risk so that this catastrophe in the care of our patients doesn’t happen.

However, over the 40-year period of the study, suicide rates decreased, most notably among lung cancer patients compared with breast, prostate and colorectal.  Cancer diagnosis counseling is an established practice, especially for a depressed patient, and referral for ongoing psychological support and counseling typically does not happen.  This is a definite lost opportunity to help patients with a devastating diagnosis.

Dr Fredda Branyon