Cancer is not just a physical disorder. It can trigger mental disorders that surface long after it has been cured or gone into remission. Anxiety and depression complicate the already complex process of battling cancer, and health care providers are drawing attention to this psychological part of the healing equation.
At the 2013 annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago, Christopher Recklitis, PhD, MPH, director of research for the Perini Family Survivors’ Center at the Dana-Farber Cancer Institute in Boston, Massachusetts, presented new, unpublished research on the tendency of cancer survivors to contemplate suicide even after learning they are cancer free.1
In his presentation at ASCO, Recklitis discussed a study he oversaw of 700 survivors of prostate cancer. Of this pool of mostly older white males, 12% reported having contemplated committing suicide at some point after being told they were cancer free. The research is currently in the process of being published, Recklitis said.
Entertaining the idea of suicide after being told you have beaten cancer is evident even in those who overcame cancer at a young age and were given their future back. In an earlier study conducted by Recklitis, 7.8% of cancer survivors who beat the disease in childhood and lived to adulthood reported having suicidal thoughts.2 According to this study of childhood-cancer survivors, “Survivors of brain and central nervous system cancers were the most likely to experience suicidal thoughts (10.6%), while survivors of non-Hodgkin lymphoma were the least likely (6.7%).”
Why would a cancer survivor who is given the best news—that they are cancer free—contemplate suicide? And what role should oncology nurses play in preparing cancer survivors for life without the disease and its medical regimen?
Recklitis said a number of factors, not just cancer, play a part in any suicidal thoughts a person who survived cancer might have, and the mindset of a cancer survivor should be discussed before the patient is discharged from treatment. Cancer survivors experience a logjam of emotions that are often reduced, ignored, or deposited beneath the overarching experience of surviving the disease. An immense amount of paranoia can appear in patients told they have survived cancer, Recklitis explained. Patients may ask
- When will my cancer reappear?
- What if I want to have children and cannot?
- How were my heart and lungs affected by chemotherapy treatment?
- How far am I behind in work? Or school?
- How is my financial situation?
- Can I keep insurance?
- Will my sexual relationships change?
Recklitis has a term for this. He refers to it as a pile-up effect. “Cancer isn’t the only thing that is happening in a patient’s life.” Recklitis believes nurses play a key role when it comes to communication with cancer patients about subjects that might be on their mind other than the disease.