Doctor urges health-care workers to be alert to suicide risk amongst cance...( to react through self-directed violenc...),Health

One apparent anomaly was that, although poor prognosis was associated with higher risk, pancreatic cancer, which has generally a very poor outlook, did not carry any higher suicide risk than that of other cancers. Refusal by the patient of either surgical or radiotherapy treatment did not heighten risk: however there was a statistically significant higher risk of suicide when surgery was deemed contraindicated indicative of advanced cancer or additional health problems.

"Clearly, any conclusions about risk factors can only be speculative," said Dr Kendal. "It could be that in cancers where surgery or radiotherapy were not deemed appropriate, patients felt a sense of hopelessness. In cancers, such as those of the head and neck, particularly oropharyngeal cancer, where pain and difficulty feeding are factors, or in myeloma where we see a lot of chronic pain, weakened bones and fractures, quality of life issues might play a role."

He said that, within this particular study, it was not possible to differentiate from the data between suicides associated with affective illnesses or substance abuse versus those motivated by desire for relief from terminal illness or the avoidance of being a burden to others.

"However, the data did confirm that married status lowered the risk of suicide and, overall, it seems plausible to conclude that depression played a likely role in many of the suicides."

Dr Kendal concluded: "We must get the message out to physicians, nurses and social workers that they should be aware of the potential for suicide in their cancer patients and that maybe, by giving people in need, and their families, more support and providing better symptom control we might be able to foster the desire to continue living."

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Contact: Margaret Willson
m.willson@mwcommunications.org.uk
44-015-367-72181
European Society for Medical Oncology
18-Oct-2006