Two new studies of millions of people around the world suggest that #doctors should be thinking more about #cancer #patients’ #mentalhealth, experts said.

By Jessica Wapner

One day years ago, during her training in neurology, Dr. Corinna Seliger-Behme met a man with end-stage bladder cancer. Before the diagnosis, the man had a stable family and job, and no history of #mentalhealthproblems, Dr. Seliger-Behme recalled. But, soon after learning of his terminal disease, he tried to kill himself with a knife in the bathtub. He spent the last week of his life in the psychiatric ward.

That patient’s situation was extreme, but the psychological distress brought on by #cancer is significant for many #patients. Two studies published on Monday quantify the psychological burden of #cancer in fine detail, pulling from much larger data sets than previous research. The findings make a compelling case for oncologists to have more discussions with their #patients about #mentalhealth struggles.

“Probably, we can prevent #suicide if we talk about it, and if we really start that early,” said Dr. Seliger-Behme, a neurologist at Heidelberg University in Germany.

In one of the new reports, she and several colleagues reviewed 28 studies that included more than 22 million cancer #patients across the world. Their analysis showed that the #suicide rate was 85 percent higher for people with cancer than the general population. Predictably, cancers with the best prognoses — including prostate, nonmetastatic melanoma and testicular cancers — had the lowest #suiciderates, whereas those with the worst prognoses, like stomach and pancreatic cancers, had the highest #suicide rates.

#Suicide rates among people with #cancer were notably higher in the #UnitedStates than in Europe, Asia or Australia, the study found. The authors speculated that the high cost of health care in the #UnitedStates might have led some #patients to forgo treatment to avoid bankrupting their families. They also wondered if easier access to firearms in the #UnitedStates compared to countries in other world regions could have contributed to the higher #suicide rates.

In the second new study, Alvina Lai, who studies informatics at University College London, and a colleague created a large database, gleaned from the health records of about 460,000 people with 26 different cancers who were diagnosed between 1998 and 2020 in Britain.

Five percent of #patients were diagnosed with #depression after their cancer diagnoses, and the same was true for #anxiety. About one percent of the group had self-harmed after their diagnoses. #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 disorder, the study found. And psychiatric issues, including substance abuse, tended to increase over time, even years after a diagnosis.

The analysis showed that the single biggest risk factor for developing a #mentalhealthcondition was treatment involving surgery, radiation and chemotherapy. The length, intensity and cumulative side effects of this triple-threat approach to cancer treatment could explain why it triggers #depression, #anxiety and even #personalitydisorders in many people.

Chemotherapy on its own was also tied to high rates of #psychiatricdisorders, whereas “kinase inhibitors” — targeted drugs that often have fewer side effects — had the lowest rates.

The stark data made Dr. Lai wonder whether #patients are given enough opportunities to weigh the psychological risks of potential treatments. “It would be so useful for #cancer #patients who are newly diagnosed to see what the data tell us and make an informed decision,” Dr. Lai said.

The study also yielded some surprising findings. For example, testicular cancer carried a higher risk of #depression than any other cancer type, affecting 98 of every 100 #patients.

“That’s slightly counterintuitive — it’s one of the better prognosis forms of cancer,” said Dr. Alan Valentine, chair of the psychiatry department at M.D. Anderson #Cancer Center in Houston, who was not involved with the study. The finding, he said, underscores how tumultuous a diagnosis can be even when a tumor doesn’t cut life short.

#JamesDonaldson notes:

Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.

Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.

Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle

Order your copy of James Donaldson’s latest book,

Celebrating Your Gift of Life:

From The Verge of Suicide to a Life of Purpose and Joy

 

New Developments in Cancer Research

Progress in the field. In recent years, advancements in research have changed the way cancer is treated. Here are some recent updates:

Pancreatic cancer. Scientists are exploring whether the onset of diabetes may be an early warning sign of pancreatic #cancer, which is on track to become the second leading cause of cancer-related deaths in the U.S. by 2040.

Chemotherapy. A quiet revolution is underway in the field of cancer treatment: A growing number of #patients, especially those with breast and lung cancers, are being spared the dreaded treatment in favor of other options.

Prostate cancer. An experimental treatment that relies on radioactive molecules to seek out tumor cells prolonged life in #men with aggressive forms of the disease — the second-leading cause of cancer death among #American #men.

Leukemia. After receiving a new treatment, called CAR T cell therapy, more than a decade ago, two #patients with chronic lymphocytic leukemia saw the blood cancer vanish. Their cases offer hope for those with the disease, and create some new mysteries.

Esophageal cancer. Nivolumab, a drug that unleashes the immune system, was found to extend survival times in #patients with the disease who took part in a large clinical trial. Esophageal #cancer is the seventh most common cancer in the world.

Because studies assessing #mentalhealth are typically based on questionnaires that rely on self-reporting, the data probably underrepresents reality, noted Wendy Balliet, a clinical #psychologist at the Hollings Cancer Center at the Medical University of South Carolina in Charleston. Persistent #stigmas against #psychiatricdisorders mean that people may not be forthcoming about their internal struggles, Dr. Balliet said. She also noted that the complexities involved in declaring a death as a completed #suicide may also lead to underreporting of the connection between #cancer and fatal self-harm.

The results raise questions about how much more counseling and support #patients could be given along the way. “It’s hard for me to not to think about what conversations these #patients are having with their oncologists,” Dr. Balliet said.

The studies also draw attention to cancer #patients with previously diagnosed #psychiatricdisorders, such as #schizophrenia. Previous research has found that such #patients die from cancer at higher rates than those without these conditions. Dr. Lai’s study found that cancer #patients with #schizophrenia were more likely to receive palliative care, potentially indicating that they didn’t get the treatment they needed early on in their diagnoses.

“Cancer is an expensive disease,” said Dr. Valentine of M.D. Anderson, “and you could argue that folks with severe #mentaldisorders either don’t have access to care or are in a health care system that doesn’t have the resources they need.”

Current treatment guidelines suggest screening for #depression as part of routine cancer care, noted Dr. Nathalie Moise, professor of medicine at Columbia University’s Vagelos College of #Physicians and Surgeons. “I think these findings may support the need to also screen for #suicide and other risk factors,” she said.

“Normalizing #mentalhealthtreatment as an integral component of your overall cancer care may also go a long way,” she said.

If you are having thoughts of #suicide, call the #NationalSuicidePreventionLifeline at 800-273-8255 (TALK) or go to SpeakingOfSuicide.com/resources for a list of additional resources.