“People who had these thoughts
of being better off dead were likely
to have high levels of emotional
distress and high levels of pain,”
Walker says. “But we know that
the main link with suicide is
depression.”
DEPRESSION AND BEYOND
Suicide is strongly associated with
severe depression: Some studies
cite a correlation as high as
90 percent. According to the
American Cancer Society, one in
four people with cancer suffer from
clinical depression, which can be
difficult to diagnose and even more
of a challenge to treat.
“Addressing underlying
depression is important,” says
Matthew Miller, an oncologist and
epidemiologist at the harvard
School of Public health in Boston.
But everyone who commits suicide
is not clinically depressed, he
cautions.
In a third study published in
the Oct. 10 JCO, Miller and his
colleagues looked at the suicide
rate among people 65 and older.
Those with cancer were more likely
to kill themselves than were people
with any other serious medical
problem, the researchers found.
“The difference in suicide risk
is not explained by higher rates
of depression among cancer
patients,” Miller points out.
“There’s something about cancer
that appears, at least in our study,
to heighten the risk of suicide
above and beyond that which can
be explained by diagnosed mental
illness or its treatment.”
The clinical diagnosis of
depression doesn’t catch all
suicidal thoughts, he explains.
Previous studies suggest that
hopelessness, lack of social
support and physical limitations
might have a larger influence on
the psychological well-being of a
cancer patient than was previously
thought.
TALKING ABOUT THE PROBLEM
Research has shown that many
patients do not receive the
help they need to deal with the
psychosocial impacts of cancer,
according to Misono. “Clinicians
should facilitate communication
about emotional health and
psychological distress, such as
feeling depressed, overwhelmed or
hopeless,” she says, “and inquire
