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Study: Cancer diagnosis immediately leads to risks

Thursday April 5, 2012
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People diagnosed with cancer have a markedly increased risk of suicide and cardiovascular death during the period immediately after receiving the diagnosis, according to a study.

Previous studies have shown cancer patients are at higher risk of suicide and cardiovascular death, but those studies ascribed the higher risk to the emotional strain of living with the potentially fatal disease and undergoing treatment that may be physically demanding, noted researchers of the latest study.

The new data suggest receiving the diagnosis in itself may be associated with a marked increase in the risk of stress-related disease and death.

In the study, published in the April 5 issue of the New England Journal of Medicine, a team of researchers followed more than 6 million residents of Sweden from 1991 to 2006. During that time, more than 500,000 people were diagnosed with cancer.

In all, only a small proportion of patients committed suicide immediately after being diagnosed with cancer. However, the risk of suicide during the first week following the diagnosis was 12 times higher than in people without cancer. Similarly, the risk of cardiovascular death was six times higher during the first week and three times higher during the first month after a cancer diagnosis, compared to people without cancer. Risk elevation of both suicide and cardiovascular death decreased rapidly thereafter during the first year after diagnosis.

Furthermore, the researchers said, risk elevation was most pronounced in malignancies with a poor prognosis, such as lung and pancreatic cancers, and least pronounced in skin cancer.

The researchers said the fact that the risk elevation was apparent directly after cancer diagnosis, and decreased in magnitude over time, supports the conclusion that the risk increase may be traced to the diagnosis itself rather than the emotional or physical suffering related to the progression of cancer or to its treatment. Nor was the risk elevation explained by previous medical history, with the researchers observing increased risk both in patients who previously had been admitted for psychiatric or cardiovascular conditions and in those with no such history.

"Both suicide and cardiovascular death can be seen as manifestations of the extreme emotional stress induced by the cancer diagnosis," Fang Fang, PhD, a researcher in the Department of Medical Epidemiology and Biostatistics at Karolinska Institutet in Sweden, said in a news release. "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."

The researchers said the new understanding of the serious consequences of a cancer diagnosis has great implications for the relatives and healthcare providers of cancer patients.

"Our study may, we hope, lead to improvements in the care of newly diagnosed cancer patients and hopefully diminish the risk of stress-related disease and death," Fang said.

To view the study data and access the study via subscription or purchase, visit http://bit.ly/I2aGVU.


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