Cancer Surgery Linked to Higher Risk of Suicide

Suicide rates are significantly higher among people who undergo cancer surgery, with half occurring within the first three years after the operation.

Cancer may have a devastating effect on both physical and mental health, making the patient feel anxious, afraid, or distressed. An estimated 6% to 38% of cancer patients develop major depressive symptoms following surgical treatment.

There is a lack of research on suicide risk among these patients, but scientists at Harvard-affiliated Massachusetts General Hospital (MGH) decided to investigate the connection. Looking at data from 1,811,397 people who underwent surgery for the 15 deadliest cancers, they found that between 2000 to 2016, suicides occurred in 1,494 (0.08%) of patients who underwent cancer operations.

Compared to the general population, the rate is significantly higher among those who underwent surgery for 10 specific cancers: the larynx, oral cavity and pharynx, esophagus, bladder, pancreas, lung, stomach, ovary, brain, colon, and rectum.

According to the study published in JAMA Oncology, male, white, divorced, or single patients are at the highest risk of suicide. Moreover, 21% and 50% of suicides occurred within the first year and the first three years after the surgical treatment, respectively. This is the period when many cancer patients have regular follow-ups with healthcare professionals.

"Thus, this period is an opportunity to potentially develop and implement programs to regularly screen patients for distress and ensure that patients have access to the appropriate support and treatment if needed," says the study’s senior author Chi-Fu Jeffrey Yang, a thoracic surgeon at MGH and an assistant professor of surgery at Harvard Medical School.

Yang notes that screening for psychosocial distress is recommended for all cancer patients, regardless of the treatment they receive.

According to the American Cancer Society, you can manage the distress that comes with the disease by:

• Relying on ways of coping that have helped you in previous crises. For example, find someone you are comfortable talking to about your illness or turn to things that usually make you calmer, such as meditation or listening to music.
• Join support or self-help groups if they make you feel better, but do not force yourself to use them.
• Explore spiritual and religious beliefs and practices that may have helped you in the past.
• Find a doctor you respect and trust who lets you ask and answer all your questions. Keep track of your medical records.
• Keep a journal to process the journey.

The researchers hope these findings will spur efforts to develop effective suicide screening strategies.