Bad news from the doctor is discouraging for both patients and their families. A diagnosis of cancer may be particularly disheartening, and a recent study finds that the risks of suicide and death from heart disease rise in the week immediately following the news.
Writing in the New England Journal of Medicine, the researchers theorize that it is the psychological toll of the diagnosis that increases death risk, not the physical impact of living with and treating cancer
Lead author Dr. Fang Fang, a researcher in the department of medical epidemiology and biostatistics at Karolinska Institutet, and her team analyzed data on more than 6 million Swedes aged 30 and older between 1991 and 2006, using the country’s health registries. The registries included more than 500,000 people who were diagnosed with cancer during that period. The researchers then looked up the cause of death of the cancer patients and found that their risk of suicide was 12 times higher during the first week after a diagnosis than that of people who were cancer free. The risk of heart-related death was six times higher during the first week and three times higher during the first month after a cancer diagnosis than for people without the disease.
The risk of suicide was greatest for those diagnosed with more severe types of cancer like esophageal, liver and pancreatic cancer. In total, there were 786 suicides among patients diagnosed with cancer, with 29 people committing suicide in the first week after their diagnosis. The highest risk for heart disease was also during the first week, with 48,991 deaths from heart attack or stroke among patients who recently found out they had cancer.
Overall the suicide risk declined over time, but people with cancer were about three times more likely to commit suicide than disease-free people during the first year following their diagnosis.
“Both suicide and cardiovascular death can be seen as manifestations of the extreme emotional stress induced by the cancer diagnosis. The results of this study indicate that the mental distress associated with being given a cancer diagnosis may bring about immediate and critical risks to mental and physical health,” said Fang in a statement.
Because the rise in heart attack and suicide risk happened immediately following the cancer diagnosis, the authors concluded that the diagnosis itself is what caused the spike, rather than the long-term suffering that accompanies the disease.
The authors noted that their study only touched the surface of mental health issues among cancer patients, and recommended further research. They also noted that cancer patients who were already receiving psychiatric care or treatment for pre-existing heart disease were less likely to die following diagnosis, which offers support for extending similar care for more patients.
“We do believe that we have identified a critical time window where the resources of health care providers of cancer patients needs to be directed,” study co-author Unnur Valdimarsdottir, head of the Centre of Public Health Sciences at the University of Iceland, told NPR. “The important thing is that health care professionals, cancer patients themselves and their significant others are aware of these risks, and remain observant of early signs and symptoms of such serious hazards.”