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Cancer patients are three times more likely to think they would be "better off dead" or to contemplate suicide than the rest of the population - a Cancer Research UK study reports online today.*
Patients were most likely to have these thoughts if they had substantial pain and particularly if they had serious emotional distress.
The study highlights the need for more support services to be available for cancer patients and that this is particularly important in the area of pain management.
Buy cialis pills Almost 3,000 outpatients took part in the study at the Edinburgh Cancer Centre.
The patients, who had a range of cancers, answered a computerised questionnaire about their physical and emotional symptoms.
Among the questions, patients were asked: "Over the last two weeks how often have you been bothered by the following problem: thoughts that you would be better off dead, or of hurting yourself in some way?" Patients could answer: "not at all," "several days," "more than half the days" or "nearly every day."
Of the 2,924 patients who took part, nearly 8 per cent said they had thoughts of being better off dead or of hurting themselves. This compares with a figure of just 2.6 per cent in a similar survey of the general population conducted in Australia.
Lead author Jane Walker, based at the Edinburgh University, said: "It is worrying that, despite improvements in cancer care, a substantial number of patients feel they would be better off dead.
"We know that depression is common in patients who have cancer but it is often missed. Pain is also a big problem. Treating patients’ symptoms as well as their disease might improve, and even save, their lives."
Dr Lesley Walker, Cancer Research UK’s director of cancer information, said: "It is normal to experience distress after a cancer diagnosis. But for some patients emotional distress or depression becomes a problem in itself and may lead to suicidal thoughts. Cancer specialists and GPs can provide treatment, with the help of psychiatrists if necessary."
*Journal of Clinical Oncology
About Cancer Research UK
- Together with its partners and supporters, Cancer Research UK’s vision is to beat cancer.
- Cancer Research UK carries out world-class research to improve understanding of the disease and find out how to prevent, diagnose and treat different kinds of cancer.
- Cancer Research UK ensures that its findings are used to improve the lives of all cancer patients.
- Cancer Research UK helps people to understand cancer, the progress that is being made and the choices each person can make.
- Cancer Research UK works in partnership with others to achieve the greatest impact in the global fight against cancer.
Cancer Research UK
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Although maternal suicide after giving birth is a relatively rare occurrence, suicide attempts often have long-lasting effects on the family and the infant. In a study published in the August 2008 issue of the American Journal of Obstetrics & Gynecology, researchers compared two populations of mothers and found that a history of psychiatric disorders or substance abuse was a strong predictor of post-partum suicide attempts.
Using the hospitalization and birth records from Washington State, USA, from 1992 to 2001, the researchers found that 335 women had been hospitalized for suicide attempts. Another 1420 women who had given birth but had not been hospitalized for a suicide attempt served as a control group.
After adjusting for fetal or infant death and other variables, women who had been previously hospitalized for psychiatric disorders were more than 27 times as likely to attempt suicide as women without this medical history. Buy generic zithromax Women with a history of substance abuse were six times as likely to attempt suicide, while psychiatric hospitalization and substance abuse together increased the risk by 11 times.
Writing in the article, Katherine A. Comtois, PhD, lead investigator from the Harborview Injury Prevention and Research Center and the University of Washington School of Medicine, states, "In the current study, we focused on preexisting psychiatric risk factors for postpartum suicide attempts resulting in hospitalization. Most importantly, a prior psychiatric or substance use diagnosis among postpartum women significantly increased the risk of a serious postpartum suicide attempt. One implication of this study is that screening for past history of psychiatric and substance use diagnoses as part of routine prenatal care may be a means of identifying women at high risk of postpartum suicide attempt, although a recent review of prenatal screening for depression cited insufficient evidence to recommend screening as a way to improve outcomes."
A recent recommendation from The American College of Obstetricians and Gynecologists suggested screening for psychosocial risk factors, including depression during prenatal care. This article emphasizes the need for more careful follow-up of postpartum women with current or past psychiatric diagnoses or substance use. The authors continue, "Future studies should evaluate the effectiveness of screening for psychiatric and substance use disorders on decreasing adverse outcomes such as suicide attempts during the postpartum period. If found to be effective, such interventions may prevent the devastating impact associated with postpartum suicide attempt."
"Psychiatric risk factors associated with postpartum suicide attempt in Washington State, 1992-2001"
Katherine A. Comtois, PhD; Melissa A. Schiff, MD, MPH; and David C. Grossman, MD, MPH.
American Journal of Obstetrics & Gynecology, Volume 199, Issue 2 (August 2008).
Click here to see Featured Article online
This study was supported by a grant from the American Foundation for Suicide Prevention.
Elsevier Health Sciences
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Researchers have spent decades probing the causes of depression, schizophrenia and insomnia in humans. Buy generic levitra But a new study in this week’s PLoS Biology may have uncovered key insights into the origins of these and other conditions by examining a most unlikely research subject: worms.
The project, which was led by Oklahoma Medical Research Foundation scientist Kenneth Miller, Ph.D., examined the way eye-less microscopic worms known as C. elegans shy away from certain kinds of light. The researchers made several key findings, chief among them that exposing paralyzed C. elegans to ultraviolet light restored normal levels of movement in the worms.
Miller’s group at OMRF traced the light reaction to a tiny molecular sensor, which is encoded by a gene they named LITE-1. "This sensor doesn’t resemble any other light sensors previously discovered," said Miller.
Although humans lack this ultraviolet light sensor, Miller’s discovery provides a window for understanding how the molecular signals in our nerve cells allow them to talk to each other to produce perceptions, behaviors, learning and memory.
"That doesn’t mean shining an ultraviolet light on people in wheelchairs will suddenly allow them to walk," said Miller. "But it does give us a tool that we can use to solve the mysteries of nerve cell communication and could ultimately help us understand the biology of everything from sleep and memory to depression."
"The new work from Ken Miller’s lab has identified a new way that organisms can sense light, distinct from the previously known light-sensing mechanism used in the eye," said Michael Koelle, Ph.D., of the Yale University School of Medicine. "It will be interesting to see whether the LITE-1 light-sensing mechanism will also lead to new insights into human sensory perception."
Despite 35 years of intensive research by hundreds of labs studying C. elegans, no one had discovered that eye-less worms can respond robustly to light. Miller’s group found the light response when they began studying worms that were paralyzed because of a gene mutation.
In prior studies, Miller and his colleagues showed that this mutation disrupts a molecular network of pathways that controls how nerve cells send signals to each other at synapses, the points where different neurons touch each other. Those same nerve cell pathways are all present in the human brain, where they are thought to play a role in controlling behaviors, learning and memory, and may also be involved in causing human neurological disorders.
"Without signals from this network, neurons cannot talk to each other or to muscle cells to produce movement, so the mutants just lie paralyzed on the culture plate even if you poke and prod them," Miller said.
But when Miller turned a short wavelength light-like ultraviolet rays-on the worms, it created a new signal in the neurons, allowing the animals to move as long as the light was on them. The same response had not been found previously in normal C. elegans because those worms have no trouble moving. Miller said he thinks the worms are hardwired to avoid damaging or lethal doses of direct sunlight, which includes UV rays.
"When you are only a few cells thick, getting a sunburn is fatal," he said.
Miller emphasized that the research is still in its early stages. "We’re a long way from any treatments based on this research, but I think we’ve opened up a door that we didn’t know was there before," he said. "There’s a lot of work left to be done, but I’m excited to see where this discovery leads us."
A novel molecular solution for ultraviolet light detection in Caenorhabditis elegans.
Edwards SL, Charlie NK, Milfort MC, Brown BS, Gravlin CN, et al. (2008)
PLoS Biol 6(8): e198. doi:10.1371/journal.pbio.0060198
Click here to view article online
Public Library of Science
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Depression causes patients with advanced cancer to die sooner than they should, say scientists at the University of Liverpool.
In a six-month study patients who were found to be depressed had a 7% increased chance of dying and this percentage increased depending on the severity of the depression. Depression is common in patients with advanced cancer and in a significant number of patients it is persistent.
The researchers examined symptoms and mood in patients using a screening method originally devised for postnatal mothers, containing questions on worthlessness, subjective sadness and suicidal thoughts as well as questions about symptoms and pain. Depression affected 29% of patients at the initial screening and 54.5% of surviving patients remained depressed eight weeks later.
Professor Mari Lloyd-Williams from the School of Population, Community and Behavioural Sciences said: "Previous research has shown that stroke patients who were depressed did not regain function as well as other patients and they had a higher risk of dying - all patients who have suffered a stroke are now screened for depression but this is not the case for patients at any stage of cancer.
"We know that a patient’s mental state affects their physical state but not enough is known about why this happens. We believe that when someone is depressed they lose motivation and therefore the will to live.
"Depression affects 25% of patients with advanced cancer but at this stage it is difficult to diagnose. Whilst patients with advanced cancer are clearly very ill they can still be effectively treated for depression but the first step in the treatment is the recognition that the patient is depressed."
Professor Lloyd-Williams and her team have been awarded ??2.5 million to carry out further research in palliative care. They are currently working on a larger study of more than 400 patients to identify what emotional and psychological health problems cancer patients experiencing in order to better understand their mental health needs and how to improve their primary care.
Buy viagra without prescription The University of Liverpool is a member of the Russell Group of leading research-intensive institutions in the UK. It attracts collaborative and contract research commissions from a wide range of national and international organisations valued at more than ??108 million annually.
University of Liverpool
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