Summary: One of the leading causes of death for cancer patients is not solely the cancer itself. Many times, mental health plummets with diagnosis, leaving the patient feeling lost and that their life is spiraling out of control. Suicide is one of the leading causes in patient death due to cancer. Removing the stigma from mental health care can help to promote conversation and communication about the issues. If you or your loved one is struggling with suicidal thoughts, reach out to your doctor or call the national suicide hotline immediately. Here you can learn the risk factors and how to help prevent suicide in your cancer patient friends and family members.
This is a topic and fact of cancer that is not often spoken about, but that takes the lives of six percent of those patients diagnosed with cancer. That topic is suicide. While we do not hear about cancer and suicide as often as we should, the rate of suicide among those cancer patients who have troublesome treatments or failed treatments is exponentially high.
A study done in early 2019 showed that suicide is the most common within the first three months after a cancer diagnosis. In general, cancer patients face a doubled-risk level being prone to suicide or suicidal thoughts. For those patients who are newly diagnosed with cancer, they face a thirteen-times greater risk for succumbing to their suicidal thoughts than the rest of the population. The Center for Disease Control defines suicidal ideation as thinking about, considering, or planning for their suicide. Suicidal ideation happens in roughly five percent of cancer cases. Even when treatment is working and the patient is in full remission, these thoughts and feelings can still creep in.
Who is at risk for suicidal thoughts during their cancer journey?
Any cancer diagnosis is devastating, life-altering and something each patient must adjust and come to terms with on their own. This is why anyone who is facing a long journey with cancer is at risk. If someone you love appears suicidal, even if the reason seems insignificant to you, take them seriously. The majority of people who kill themselves have a treatable mental health condition.
The most common risk factors for suicide in people with cancer include:
- Age – People with cancer over the age of sixty-five are more likely to commit suicide than those who are younger. Suicide rates are the highest in men over the age of eighty.
- Sex – Men with cancer are much more likely to commit suicide than women with cancer.
- Timing – The first year after diagnosis is the period of greatest risk. Another recent study found that half of the suicides in cancer patients occurred in the first two years following diagnosis.
- Cancer type – Suicide is more common among people with lung, prostate, pancreatic, esophageal, stomach, and head and neck cancer and laryngeal cancer. One study found that male patients with pancreatic cancer had a suicide risk eleven times that of the general population. A 2017 study by the American Thoracic Society found that of all cancers, those with lung cancer have the highest risk of suicide. In that study, the risk of suicide for all cancers combined was sixty percent higher than for those without cancer. Among those with lung cancer, the risk was four-hundred-twenty percent higher than average.
- Race – Suicide rates appear to be higher in non-Hispanic whites than in other races.
- Poor prognosis – People who have a cancer that carries a poor prognosis are more likely to consider suicide than those with earlier stages of the disease. Metastatic disease, which is cancer that has spread to other regions of the body, is associated with a higher risk of suicide.
- Pain – Pain that is inadequately controlled is associated with a higher risk. Thankfully, most cancer pain can be controlled, and many cancer centers now offer palliative care teams to help address the symptoms of cancer and its treatments.
- Depression and Anxiety – It was found that people who experience depression, anxiety, or posttraumatic stress syndrome in addition to cancer have significantly more suicidal thoughts than those who don’t experience these symptoms.
- Inability to Work – Suicidal thoughts were six times more common in people who were unable to perform the duties required by their job.
- Spirituality – In a few studies, people who stated they had “no religion” experienced significantly more suicidal thoughts than those who attended religious services.
- Social factors– People who were not married were more likely to attempt suicide than those who were married. Suicide was also more likely in people without a high school education.
What are the general risk factors for suicide during the cancer journey?
There are many factors that can increase your overall risk for suicide. Some of the most common to consider are:
- A family history of suicide, depression, or mental illness
- Previous suicide attempts
- Having a plan as to how they would commit suicide
- Access to firearms
- A sense of hopelessness
Knowing the facts about suicide and cancer can help to prevent losing a friend or loved one during their times of trial. Understanding the signs and symptoms can be difficult for some to interpret. In some cases, there are no real ways to foresee a suicide happening, and the patient remains acting like nothing is wrong until their sudden end. These are the most commonly seen and noted warning signs to watch for in patients with cancer.
- Having a plan about how they would commit suicide.
- Giving away things of importance.
- Engaging in risky behavior – Such as driving too fast or skipping needed medications.
- Suddenly acting happy or calm after a period of appearing down and depressed.
If your intuition or gut feelings are telling you that something is wrong, or that your family member or friend may be struggling, even if none of these warning signs are present, have a serious conversation about the things that you have noticed. Reaching out could be the very thing that your person needs to reconnect and climb from their darkness.
What can I do to lower the risk of suicide in a loved one?
In most cases, people will commit suicide regardless of who steps in, what is done, or how situations change. Occasionally there are things you can do to try and reconnect your person with their life. These acts of prevention can help you to be more aware of any suicidal thoughts.
- Be aware. Know the warning signs.
- Listen. Allow your loved one to vent. Many people who attempt suicide are feeling overwhelmed. Just talking may lift some of the burden. Avoid offering quick solutions, and instead, listen to your loved one’s concerns.
- Do not judge. You may not understand why your loved one feels so desperate. Their problem may not seem insurmountable to you, but it may feel that way to them. Listen empathically.
- Express your love. Even if your loved one feels your love it helps to hear it as well. One of the great fears people with cancer carry is that of being a burden to others. Remind your loved one of the joy they bring to your life, even with a diagnosis of cancer.
- Ask. You may be afraid to bring up suicidal thoughts for fear that it may put an idea in your loved one’s head. That is not true. Three important questions to ask that might indicate a level of one’s suicidal risk include: Do they know how they would commit suicide? Do they have the supplies available and do they know when they would do it?
- Share. If you have concerns, it is important that you ask for help from other loved ones and friends. Your loved one may ask you not to talk to others, but this is something you should not have to carry alone.
- Seek professional help. If your loved one is feeling hopeless about treatment or experiencing pain, a palliative care specialist may be able to offer assistance. Their oncologist or primary physician may be able to recommend a psychiatrist or psychologist to help manage the emotional pain that has led to thoughts of suicide.
- Make sure weapons are out of reach. Preferably remove any weapons from the home if possible.
- Do not leave them alone. Make sure you, or someone else you trust, stays with your loved one while they are feeling hopeless or until appropriate mental health professionals can assess your loved one.
If you are having suicidal thoughts, it is very important to talk to someone you trust. Don’t be afraid to accept professional help. A diagnosis of cancer can seem overwhelming, but people are available to help you through each step. Do not try to be a hero and do this alone. There is a tendency to “reward” people with cancer for being “courageous.” But nobody has to suffer in pain; either physical or emotional. Sometimes the courageous act is asking for appropriate help with one’s physical and emotional pain.
If you or a loved one have attempted suicide, dial 911 immediately. If you believe a loved one has made an attempt, and while awaiting emergency responders, gather any medications present. Ask your loved one about any medications taken, the use of alcohol, and any medical conditions that the emergency response team should be aware of.
If you just need to talk to someone right now, but you or your loved one are safe and not suicidal, call the National Suicide Prevention Hotline at 1-800-273-8255.
Center for Disease Control
American Thoracic Society