Suicide burden weighs heavily on cancer load
New study finds cancer quadruples the risk of taking your own life
Every year, when 100,000 South Africans get the news that nobody wants to get, there is another silent enemy lurking in the shadows: a new study just published has shown that people diagnosed with cancer are more than four times more likely to commit suicide than people without cancer. This is according to researchers at Penn State College of Medicine who just had their report published in Nature Communications.
The study focused on more than eight million cancer patients in America, and researcher Nicholas Zaorsky, a radiation oncologist who led the research, said that although cancer is a leading cause of death, “cancer patients do not die from cancer”. They usually die of another cause.
“There are multiple competing risks for death, and one of them is suicide. Distress and depression can arise from cancer diagnosis, treatment, financial stress and other causes. Ultimately, distress and depression may lead to suicide. Our goal was to quantify the risk of suicide among cancer patients.”
He added that while “progress has been made in treating the cancer itself”, not as much work and research has been put into how cancer affects patients mentally and emotionally. The researchers compared the suicide risk of cancer patients versus the general public, and they explored whether certain cancer patients had a higher risk than other patients.
Interestingly, it was found that of the cancer sufferers, those most likely to take their own lives included white males, and patients diagnosed at a younger age. The types of cancer also played a role: lung, head and neck, testicular cancer and lymphomas were more likely to increase the risk of suicide in the patient.
Also, the researchers found that while the risk of suicide decreases five years after a diagnosis, the risk remains high for patients with Hodgkin lymphoma and testicular cancer.
Also, says Zaorsky: “Treatments for some cancers – like leukemia and testicular cancer among adolescents and young adults, for example – can decrease a patient’s fertility, and that seems to be one of the risks for suicide in the long term. In contrast, elderly patients who are diagnosed with lung, prostate and head and neck cancers are at an increased risk of suicide for the remainder of their life.”
The researchers said the results could be used to help identify patients who may be at a higher risk for suicide, and help healthcare providers tailor their treatments accordingly.
So, what is the significance of this study in the SA context?
The first thing to note is that a quarter of South Africans are affected by cancer: according to the Cancer Association of South Africa, apart from the 100,000 diagnosed every year, this figure of a quarter includes those who are affected because a family, friend, colleague or loved one is diagnosed. The other notable statistic is that 90% of all our cancers are caused by lifestyle factors including smoking, diet and lack of exercise. The association also reports that the survival rate is six out of 10.
What about gender? The lifetime risk for SA men of having cancer is one in six, and for women one in nine. This is of particular importance when seen in the context of our suicide patterns: In SA, white men in particular are more susceptible to suicide than other population groups. According to the Medical Research Council, suicide rates among white men in a given year are 2.5 times higher than the national suicide rate and 1.4 times higher than the national male suicide rate.
But is cancer, as per an oft-held claim, more of a “white person’s disease”? According to Dr Elvira Singh, head of the South African National Cancer Registry, it is not. This perception arises from uneven diagnostics in the context of race and socio-economic inequality.
“In South Africa, race is often a proxy for socioeconomic status and particularly access to healthcare. It has been reported that white and Asian populations more commonly access private healthcare in South Africa, where diagnostic, and particularly screening facilities may be more readily available,” Singh told Africa Check when this myth was analysed.