Better Off Dead: Suicidal Thoughts in Cancer Patients
University of Edinburgh Cancer Research Centre, School of Molecular and Clinical Medicine, Edinburgh, United Kingdom EH10 5HF. Journal of Clinical Oncology
(Impact Factor: 18.43).
09/2008; 26(29):4725-30. DOI: 10.1200/JCO.2007.11.8844
Cancer is associated with an increased risk of suicide and attempted suicide. However, we do not know how many cancer patients have thoughts that they would be better off dead or thoughts of hurting themselves. This study aimed to determine the prevalence of such thoughts in cancer outpatients and which patients are most likely to have them.
A survey of consecutive patients who attended the outpatient clinics of a regional cancer center in Edinburgh, United Kingdom. Patients completed the Patient Health Questionnaire-9 (PHQ-9), which included Item 9 that asks patients if they have had thoughts of being better off dead or of hurting themselves in some way in the previous 2 weeks. Those who reported having had such thoughts for at least several days in this period were labeled as positive responders. Patients also completed the Hospital Anxiety and Depression Scale (HADS) and a pain scale. The participating patients' cancer diagnoses and treatments were obtained from the cancer center clinical database.
Data were available on 2,924 patients; 7.8% (229 of 2,924; 95% CI, 6.9% to 8.9%) were positive responders. Clinically significant emotional distress, substantial pain, and--to a lesser extent--older age, were associated with a positive response. There was strong evidence of interactions between these effects, and emotional distress played the most important role.
A substantial number of cancer outpatients report thoughts that they would be better off dead or thoughts of hurting themselves. Management of emotional distress and pain should be a central aspect of cancer care.
Available from: Abraraw Lehuluante
- "The latter is a neuroendocrine system that regulates the body’s response to stress and an imbalance in this system can cause mood disorders including suicidal ideation [4, 5]. Cancer patients can be affected, among others, by the mental and physical demands of having the diagnosis as well as stressors that have to do with disease progress and treatment . "
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ABSTRACT: The aim of this study was to explore if there were some specific factors pertinent to health-related quality of life (HRQoL) that could affect self-experienced suicide ideation in men with prostate cancer (PCa).
Questionnaires containing 45 items were distributed to members of the Swedish Prostate Cancer Federation in May 2012. Out of 6,400 distributed questionnaires, 3,165 members (50 %) with PCa completed the questionnaires. Those members expressed their experienced HRQoL and experienced suicide ideation using VAS-like scales as well as multiple-choice questions. Both descriptive and analytical statistical methods were employed. A regression model was used to explore the relationship between experienced health-related quality of life and experienced suicide ideation.
Generally, the respondents rated their self-experienced health-related quality of life as good. About 40 % of the participants had experienced problem with incontinence, and 23 % had obstructions during miction. About 7 % of the respondents experienced suicidal ideation, at least sometime. The regression model showed statistically significant relationships between suicide ideation, on the one hand, and lower self-rated health-related quality of life (P < 0.001), physical pain (P = 0.04), pain during miction (P = 0.03), and low-rated mental / physical energy (P = 0.03), on the other.
It is quite necessary to know which specific disease and treatment-related problems can trigger suicide ideations in men with prostate cancer and to try to direct treatment, care, and psychosocial resources to alleviate these problems in time.
Supportive Care in Cancer 02/2014; 22(6). DOI:10.1007/s00520-014-2150-2 · 2.36 Impact Factor
Available from: cjon.ons.org
- "National Comprehensive Cancer Network's (NCCN) Distress Thermometer as a screening tool u Demographic Factors Older age, male gender, unmarried, and race u Disease Factors High-fatality cancer, higher cancer stage, and point in disease trajectory u Associating Factors Physical symptoms (e.g., pain) and decreased performance status u Psychosocial Factors Preexisting psychopathology, depression, anxiety, hopelessness, substance abuse, family history of suicide, and isolation FIGURE 1. Suicide Risk Factors in Patients With Cancer Note. Based on information from Ahn et al., 2010; Akechi et al., 2002; Bill-Axelson et al., 2010; Emanuel et al., 2000; Filiberti & Ripamonti, 2002; Güth et al., 2011; Johansen et al., 2005; Johnson et al., 2012; Mahdi et al., 2011; Miller et al., 2008; Misono et al., 2008; Robson et al., 2010; Shim & Hahm, 2011; Suarez-Almazor et al., 2002; Turaga et al., 2011; Walker et al., 2008. "
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ABSTRACT: The risk of suicide in the cancer population is real, and it requires nurses to be able to assess and manage such risk competently. This article supports the idea that oncology nurses need to be comfortable with identifying, assessing, and appropriately triaging depressed and possibly suicidal patients with cancer to appropriate specialists, given the increased risk of suicidal ideation and completion in the cancer population. The goal of this article is to help oncology nurses identify the specific risk factors for suicide in their patients with cancer, feel confident and prepared with an accurate assessment, and provide the necessary interventions.
Clinical Journal of Oncology Nursing 02/2013; 17(1):E1-E7. DOI:10.1188/13.CJON.E1-E7 · 0.91 Impact Factor
Available from: ncbi.nlm.nih.gov
- "Psychosocial needs are often unmet in cancer treatment   and in cancer treatment centres psychosocial domains (aspects of managing daily life, emotions, and social identity) were among the highest perceived supportive needs for cancer patients in treatment as well as after treatment  . Psychosocial issues figure increasingly as the disease progresses  and it is found that emotional distress ranged highest in a study focusing on thoughts of suicide in cancer patients . Our study confirms the importance of recognizing needs for psychosocial support as the cancer disease progresses, as for our patients, throughout maybe a number of palliative chemotherapy series. "
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ABSTRACT: To analyse cancer patients' views and perspectives on mechanisms and barriers to involving the GP in the late treatment phase of advanced cancer.
Qualitative, semi-structured interview study of 16 patients with advanced cancer and their next of kin. Seven patients were re-interviewed after six months and three after 12 months.
Patients' home in Region South, Denmark.
The cancer patients described how they developed a personal relationship with the staff at the cancer treatment centre. They also described some kind of dependability towards the hospital staff and therefore consulted the doctor or the staff at the cancer treatment centre before seeking advice from their GP. Some patients found that the GP was not familiar enough with the treatments given; others that they did not want to inconvenience the busy GP with what they perceived to be minor non-treatment-related matters. However, as the disease progressed they also described how they perceived unmet psychosocial needs. After ending chemotherapy, re-establishment of the contact between patient and GP was in this study dependent on a proactive attitude by the GP.
GPs are important for cancer patients' possibility of staying at home and dying at home. This study, however, shows that due to some patients' barriers special attention is needed to guarantee the switch over from the cancer treatment centre to home-based end-of-life care. This is increasingly important as cancer patients to a still larger extent receive hospital-based, active treatment until shortly before death.
Scandinavian journal of primary health care 02/2009; 27(1):58-62. DOI:10.1080/02813430802677817 · 1.30 Impact Factor
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