BACKGROUND:
Cancer survivors have been shown to be more likely to have suicidal ideation than their same age peers. Prostate cancer survivors share this risk. They are also typically over 65, which is an age group with increased risk for suicide.
QUESTION: What are the suicide risk factors for survivors of prostate cancer?
STUDY
Dr. Christopher Recklitis surveyed prostate cancer (PC) survivors who were first diagnosed 3 to 8 years before the study. The survey asked survivors about suicidal ideation, depressed mood and demographic characteristics. The survey also inquired about pain, health-related quality of life, lifetime and recent recurrence, as well as the use of health services in the past 12 months.
The survey included:
- The 26-item Expanded Cancer Index Composite Instrument (EPIC-26) about symptoms and PC treatment.
- The Short-form 12 (SF-12).
- The Beck Depression Inventory.
- The Geriatric Depression Inventory.
RESULTS
The response to the survey was impressive, with 693 of 979 men completing the questionnaires. Over 12% of men reported some suicidal ideation, with 5.2% reporting active suicidal ideation and 1.4% reporting serious suicidal ideation. These are all levels higher than those without cancer. The factors that were associated with suicidal ideation included having a previous mental health condition, emotional and physical health, unemployment, pain, low income, and depressed mood (not clinically significant depression). The factors that were not related to suicidal ideation included age, type of cancer treatment, time since cancer diagnosis, cancer recurrence, and more.
TAKEAWAYS
-While most men fare well, some men with PC are at long-term risk for emotional and physical comfort. -Physicians should check in with their patients about their pain (physical and emotional), address concerns about side effects and mood, and assess for suicidal ideation using several questions about different periods of time.
Christopher Recklitis, Ph.D., MPH
Assistant Professor, Pediatrics
Harvard Medical School
Grant Title: Surviving Prostate Cancer but Succumbing to Suicide: Do Poor Health Outcomes Explain the Increased Risk?
2011 Pilot Research Grant
Grant-Related Publications:
Zhou ES, Hu JC, Kantoff PW, Recklitis CJ. Identifying suicidal symptoms in prostate cancer survivors using brief self-report. J Cancer Surviv. 2014 Aug 19. [Epub ahead of print] PMID: 25135206
Recklitis CJ, Zhou ES, Zwemer EK, Hu JC, Kantoff PW. Suicidal ideation in prostate cancer survivors: Understanding the role of physical and psychological health outcomes. Cancer. 2014 Jun 24. doi: 10.1002/cncr.28880. [Epub ahead of print] PMID: 24962506
Click here to read more about Dr. Recklitis' Pilot Research Grant.