Dr. Corinna Seliger-Behme encountered a guy with end-stage bladder cancer one day during her residency training in neurology. It was several years ago. As Dr. Seliger-Behme recalls, the guy was in a stable home and career situation before being diagnosed with bipolar disorder. He also had no previous history of mental health difficulties. Soon after learning of his fatal illness, he attempted to commit himself in the bathtub by stabbing himself with a knife. He was sent to the mental unit for the last week of his life.
Despite the terrible nature of that patient’s circumstance, the psychological pain brought on by illness is considerable for many cancer patients. Two studies released on Monday quantify the psychological impact of cancer in great detail, using data sets that are far bigger than those used in earlier studies. The results provide persuasive evidence that oncologists should engage in more in-depth conversations with their patients concerning their mental health difficulties.
Doctor Seliger-Behme, a neurologist at Heidelberg University in Germany, believes that if we speak about suicide and start talking about it at an early age, we may probably prevent it from happening.
A recent research by her and many colleagues examined 28 trials that included more than 22 million cancer patients from all around the globe, according to one of the publications. According to their findings, the suicide incidence among cancer patients was 85 percent greater than that of the general population. Those malignancies with the greatest prognoses, such as prostate, non-metastatic melanoma, and testicular cancers, had the lowest suicide rates, while those with the worst prognoses, such as stomach and pancreatic cancers, had the highest suicide rates, as would be expected.
According to the findings of the research, suicide rates among cancer patients in the United States were much higher than in Europe, Asia, or Australia. The authors hypothesised that the high expense of health care in the United States may have caused some patients to forego treatment in order to prevent bankrupting their family as a result of their financial situation. They also questioned if the fact that Americans had better access to weapons than people in other parts of the globe may have contributed to the higher suicide rates in the United States.
In the second new study, Alvina Lai, an informatics student at University College London, and a colleague built a large database based on the health records of approximately 460,000 people with 26 different cancers who were diagnosed between 1998 and 2020 in the United Kingdom and entered the data into a computer.
Following their cancer diagnosis, 5% of patients were diagnosed with depression, and the same was true for anxiety in the same group of patients. After receiving their diagnosis, around one percent of the cohort engaged in self-harm. Patients with brain tumours, prostate cancer, Hodgkin’s lymphoma, testicular cancer, and melanoma were the most likely to injure themselves, according to the study.
According to the findings of the research, almost one-quarter of cancer patients had a drug misuse condition. Even years after being diagnosed, psychological problems such as drug misuse continued to deteriorate with time.
In the study, it was discovered that surgery, radiation therapy, and chemotherapy were the most significant risk factors for the development of mental health problems in the general population. A possible explanation for why this triple-threat strategy to cancer therapy causes depression, anxiety, and even personality problems in so many patients might be the length of time, severity, and cumulative adverse effects of the treatment.
In the study, it was discovered that surgery, radiation therapy, and chemotherapy were the most significant risk factors for the development of mental health problems in the general population. A possible explanation for why this triple-threat strategy to cancer therapy causes depression, anxiety, and even personality problems in so many patients might be the length of time, severity, and cumulative adverse effects of the treatment.
Wendy Balliet, a clinical psychologist at the Hollings Cancer Center at the Medical University of South Carolina in Charleston, explained that because studies assessing mental health are typically based on questionnaires that rely on self-reporting, the data is likely to be underrepresentative of reality. Dr. Balliet believes that because of the persistent stigma associated with mental problems, individuals may be reluctant to speak openly about their internal issues. She also pointed out that the difficulties associated with determining whether a death was a result of a completed suicide may result in an underreporting of the link between cancer and deadly self-harm.
The findings raise issues about how much extra counselling and assistance patients should get along the road based on the findings. Doctor Balliet admits that it’s difficult not to think about the talks that his patients are having with their oncologists while he’s working.
Additionally, cancer patients who have already been diagnosed with mental diseases such as schizophrenia are being targeted by the research. Previous study has shown that people with these disorders die from cancer at a greater rate than those who do not have these problems. Cancer patients with schizophrenia were more likely than non-cancer patients to obtain palliative care, according to Dr. Lai’s research. This might indicate that they did not receive the medication they need early in their diagnosis.
‘Cancer is a costly disease,’ Dr. Valentine of the University of Texas M.D. Anderson Cancer Center said, “and you might argue that people suffering from severe mental illnesses either don’t have access to treatment or are in a health-care system that lacks the resources they need.”
Dr. Nathalie Moise, a professor of medicine at Columbia University’s Vagelos College of Physicians and Surgeons, said that current treatment recommendations include screening for depression as part of standard cancer care as part of basic cancer care.
