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While a cancer diagnosis on its own significantly raises the risk of suicide, the study found that a lung cancer diagnosis raised the odds of suicide by over four times compared to people in the general population.
"A cancer diagnosis is an overwhelming diagnosis for patients psychologically and emotionally," explained study senior author Dr. Jeffrey Port.
"It is a very tough diagnosis for patients to manage, and there is a higher suicide rate," he added.
Port is a professor of cardiothoracic surgery at Weill Cornell Medical Center in New York City.
The study included data from over 3 million patients during a 40-year period. Cancer diagnoses were linked to over 6,600 suicides. Although the study wasn't designed to prove a direct cause-and-effect relationship, the researchers found that cancer was associated with double the risk of suicide.
Among lung cancer patients, certain groups were much more likely to take their own lives. These groups included Asians, people whose cancer had spread to other areas of the body (metastatic), patients who refused surgery, older patients, widowed patients and men.
Port believes the suicide risk is so high for several reasons. First, most people consider cancer a devastating diagnosis with very little hope.
Second, lung cancer is a disease that many believe is the result of smoking, so there is a tremendous amount of guilt.
Third, many lung cancer patients have other significant medical issues due to smoking, such as heart disease. So they feel overwhelmed and become convinced that their bodies can't handle the treatment, the study authors said.
And finally, unlike breast cancer, prostate cancer or other cancers where there are great support networks available from survivors, lung cancer does not have as many survivors and therefore, the support groups, marches and solidarity are limited.
Dr. Jorge Gomez, assistant professor of medicine at Mount Sinai Hospital in New York City, said similar studies have found that the risk of suicide is higher in the beginning of cancer treatment, between the first six months to a year after diagnosis.
"Suicide that happens in the beginning of treatment is mainly caused from stress, depression, anxiety and hopelessness," said Gomez, who is also a spokesman for the American Lung Association. "There are also patients who consider suicide at the end when they are suffering significantly."
Gomez stressed that it's important for family members, friends or caretakers to look for warning signs so the depression can be treated immediately.
"Look for signs of depression, mood changes, increased sleep, decreased appetite, decreased mood," Gomez cautioned. "Make sure that the patient or caregiver talks to the physician about it and asks for it to be addressed if it isn't being addressed."
While the focus of the new study is about suicide, Port hopes this research will shed light on another, more common problem for patients diagnosed with lung cancer: how the high levels of distress, anxiety and depression associated with this diagnosis affect treatment.
Doctors know that many lung cancer patients "have anxiety and stress, and it affects their treatment," said Port. "Those patients have a harder time being able to manage their plan, keep to the plan and ultimately even make decisions about their own treatment. There is a lot of anxiety and stress about the diagnosis that really affects the treatment of the disease."
In Gomez's practice, there are social workers specifically assigned to work with lung cancer patients, which helps combat this problem.
"We have a fairly robust screening program," Gomez explained. All new patients are screened for distress, depression and suicidal ideation. If patients are identified with these issues, they're seen by a lung cancer social worker that same day, he said.
This program is something that Port would like to see take place in more oncology units throughout the country.
"We need to recognize our patients are at higher risk and then intervene," he said. "Intervention can take the form of everything from reaching out to patients to make sure they understand their treatment plan and are keeping up with their treatment plans, to sending them to other specialists in the field, such as psychiatrists and psychologists. But it begins with recognizing that there is a problem."
The study was scheduled to be presented on Tuesday at the American Thoracic Society meeting in Washington D.C. Findings presented at meetings are generally viewed as preliminary until published in a peer-reviewed journal.
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