Cancer can be a devastating diagnosis, and now two new studies show these patients are at increased risk for anxiety, depression and suicide.
The findings highlight the need for oncologists to pay more attention to their patients' mental health needs, the authors said.
In the first paper, researchers reviewed 28 studies that included more than 22 million cancer patients worldwide and found that they had an 85% higher suicide rate than the general population.
The lowest suicide rates were among patients with the best chances of good outcomes -- such as those with prostate, non-metastatic melanoma and testicular cancers -- while the highest suicide rates were among patients with the worst prognoses, like pancreatic and stomach cancers.
Cancer patients in the United States had notably higher suicide rates than those in Asia, Australia or Europe. Possible reasons for that include U.S. patients avoiding the high cost of treatment to protect their families from financial disaster and having easier access to guns, said study author Dr. Corinna Seliger-Behme, a neurologist at the University of Regensburg in Germany, and colleagues.
"Probably, we can prevent suicide if we talk about it, and if we really start that early," she told The New York Times.
In the second study, researchers analyzed the health records of about 460,000 people in Britain who were diagnosed with 26 different cancers between 1998 and 2020. The researchers found that 5% were diagnosed with depression and 5% with anxiety after their cancer diagnoses.
About 1% of patients self-harmed after their cancer diagnoses, and patients with brain tumors, prostate cancer, Hodgkin's lymphoma, testicular cancer and melanoma were most likely to hurt themselves.
About one-quarter of the cancer patients had substance abuse disorders, and rates of that and other psychiatric issues tended to increase over time, even years after a cancer diagnosis.
The single biggest risk factor for a new diagnosis of a mental health condition was combination treatment with surgery, radiation and chemotherapy. The length, intensity and cumulative side effects of this three-prong treatment could explain why it can cause depression, anxiety and even personality disorders in many people, said researcher Alvina Lai, who studies informatics at University College London.
The findings suggest that patients may not be given enough opportunities to weigh the mental health risk of potential cancer treatments, according to Lai.
"It would be so useful for cancer patients who are newly diagnosed to see what the data tell us and make an informed decision," Lai told the Times.
Visit the American Society of Clinical Oncology for more on cancer and suicide.