One might think that the feat of surviving cancer would give people a renewed appreciation for life. But the stress and emotional and often physical pain that accompany childhood cancer, even two decades later, can be debilitating enough to cause suicidal thoughts and attempts in surprisingly high numbers, according to a new study in the Journal of Clinical Oncology.

Researchers at the Harvard Medical School’s Dana-Farber Cancer Institute found that one in eight study participants (12.8%) who had cancer as children reported suicidal symptoms as adults. (Death from suicide is about .01% of the U.S. population.) The 226 participants (100 men and 126 women) were aged 18 to 64 (with average age of 28) and the average time since their diagnosis of childhood cancer, including leukemias and lymphomas, was 18 years. Suicidality outcomes were not significantly related to age or sex, but they were linked to a younger age at diagnosis, longer time since diagnosis, leukemia diagnosis, cranial radiation treatment, depression, hopelessness, pain and concern over physical appearance.

What it means: The small study involves only survivor clinic patients, who may have greater physical and emotional needs than other childhood cancer survivors, but the findings are significant in that they can guide health providers in modifying follow-up care with these groups.

Only 11 of the 29 suicidal individuals showed evidence of significant depression according to depression rating scales used in the study. This suggests that asking an individual about his or her depressive state alone is an inadequate measure in identifying people with suicidal thoughts. Previous studies have shown a link between cancer and suicidal tendencies but this is the first study to connect suicidality and physical problems (including pain and concern over appearance). And since problems with physical health, depression and pain are treatable, researchers suggest that health providers consider a multi-disciplinary approach to follow-up care to better understand cancer survivors’ health and to achieve an improvement in their quality of life.

From the Archive:

May 22, 2006: When Colleges Go On Suicide Watch
Feb. 13, 2006: Happiness Isn't Normal