SUICIDE risk in patients undergoing cancer treatments is significantly higher compared with the general population. This necessitates suicide screening strategies among those undergoing different cancer therapies; but, the association between treatment choices and suicide risk are not well known. A recent study by Michael L. Chen, Stanford University School of Medicine, California, et al. has uncovered a significant correlation between patients with cancer who do not opt for surgery and an elevated risk of suicide. The research was based on data from the Surveillance, Epidemiology, and End Results (SEER) Program, and underlined the role that surgical therapy may play in reducing suicide mortality among patients with cancer.
The study took data from 5,164,987 patients diagnosed with the 15 most common solid organ cancers between 2000 and 2020. Of these patients, 7,132 (0.1%) died by suicide. The findings revealed that patients who did not undergo surgery had a notably higher suicide risk, especially those with cancers such as pancreatic, esophageal, lung, and stomach. In pancreatic cancer, those who declined surgery faced a 598% higher suicide rate compared to the general population, with the risk surging to 1,011% if surgery was recommended but not pursued.
Patients who underwent radiotherapy or chemotherapy did not exhibit the same increased suicide risk. The researchers suggested that surgery may offer patients a sense of hope and control, while reducing feelings of anguish that can lead to suicide. They also speculated that a perceived loss of autonomy or dignity and surgical access barriers may play a role in higher suicide deaths. Further investigation is needed to elucidate the reasons for patients who do not opt for recommended surgery, and should include the role of psychiatric conditions.
Reference: Chen ML et al. Surgery and suicide deaths among patients with cancer. JAMA Netw Open. 2024;7(9):e2431414.
Anaya Malik | AMJ
