Stories You Probably Didn't Read in October: I--UPDATED

There were a number of important stories about cancer, breast cancer in particular, that were reported by the wire services in October but not picked up by magazines and newspapers.

The first of these was a report sent out by Reuters early in October that said that breast cancer survivors--SURVIVORS, not women living with the disease or in treatment--are at higher risk of suicide than other women.

This story seems to have fallen into a black news hole: No one I mentioned it to, including medical oncologists who treat women with breast cancer, therapists, and other women living with cancer, was aware of the report. (CNN was the only mainstream news outlet that I noticed had picked it up.)

I can only guess at the reasons, which would include an editorial reluctance to run a negative story during a month devoted to pink froth and feel-good stories about breast cancer, which is, after all, a pretty devastating disease, but not during October.

Reuters reported on October 6 that breast cancer survivors are 37 percent more likely to commit suicide than are other women. The report also said that the increased risk continues for at least 25 years after diagnosis. Reuters was reporting findings by Dr. Catherine Schairer, from the National Cancer Institute in Rockville, Maryland, and her colleagues that were originally published in the Journal of the National Cancer Institute.

The research was a population study that analysed data for 723,810 breast cancer survivors diagnosed between 1953 and 2001 in the United States and Scandinavia. During follow-up through 2002, a total of 836 women committed suicide, Reuters says.

What the research does not include is the why. Why did these women commit suicide?

I can understand that women might commit suicide at the time they are first diagnosed, or if they are living with a cancer that cannot be cured, but I was surprised to learn that survivors had such an increased risk of suicide.

I've asked several experts for their opinions, and I am also e-mailing the lead author of the study to see what she can add.

Dr. Robert Livingston, a well-known medical oncologist who has been treating women with breast cancer for more than 20 years, says, "I do not have an explanation for it. I have not had a breast cancer survivor who committed suicide (to my knowledge), and very few patients of mine with breast cancer and advanced disease have done so, either."

Actually, this is not surprising, even though Dr. Livingston has cared for a couple of thousand women over the years, according to Reuters the suicide rate for breast cancer survivors was 4.1 per 100,000 women per year.

I think this helps put the news story into perspective: Even though suicide among breast cancer survivors is significantly higher than for women in the general population, and should not be ignored, it is still low.

Dr. Livingston adds that this is in contrast to a number of other malignancies, like cancer
of the pancreas: "Where the incidence of suicide is unquestionably high, and is not all explained by the dire prognosis of the disease (suicidal depression is sometimes a presenting symptom of cancer of the pancreas)."

I also talked to a Seattle therapist who sees a number of patients with life-threatening illnesses, including cancer, and she said the increased suicide rate among breast cancer survivors may be due to their marriages or other relationships breaking up, and also to increased fears about their own mortality that may become overwhelming.

The next piece, of course, is for doctors, cancer survivors, and family members to be aware of this risk, and do what they can to help. More on that soon.

Read the original Reuters story:
Breast cancer survivors have increased suicide risk