Wednesday, March 30, 2022

Depression and suicide rates jump for patients diagnosed with cancer, two new studies indicate

Two new studies have found cancer patients are at a higher risk for depression and suicide.

According to a story this week by Jessica Wapner in The New York Times, the "findings make a compelling case for oncologists to have more discussions with  their patients about mental health struggles."

A caption with the story notes that one of the studies found "suicide rates among people with cancer were notably higher in the United States than in Europe, Asia or Australia." 

Dr. Corinna Seliger-Behme
The article quotes Dr. Corinnas Seliger-Behme, a neurologist at Heidelberg University in Germany, as saying, "Probably, we can prevent suicide if we talk about it, and if we really start that early."

Seliger-Behme and a colleague reviewed in their report "28 studies that included more than 22 million cancer patients across the world. Their analysis showed that the suicide rate as 85 percent higher for people than the general population."

Cancers with the worst prognoses, like stomach and pancreatic cancers, had the highest rates while the diseases with the best prognoses, including prostate, non-metastatic melanoma and testicular cancers, had the lowest.

The study's authors, according to the story, speculated that "the high cost of health care" in the U.S. might had led some patients "to forgo treatment to avoid bankrupting their families." The authors also wondered if easy access to firearms may have contributed to the higher suicide rates.

In the other new study, Alvina Lai, PhD, an associate professor at University College London, and a colleague examined health records of about 460,000 people in Britain with 26 different cancers. Five percent were diagnosed with depression, with the same number diagnosed with anxiety, after their diagnoses.

Alvina Lai, PhD

"Patients with brain tumors, prostate cancer, Hodgkin's lymphoma, testicular cancer and melanoma were most likely to hurt themselves," Wapner's piece reports.

Moreover, about 25% of the patients suffered from substance abuse — and psychiatric issues "tended to increase over time, even years after a diagnosis."

The biggest risk factor for developing a mental health condition, according to the story, was to those undergoing the triple-threat approach of surgery, radiation and chemotherapy. "The length, intensity and cumulative side effects… could explain why it triggers depression, anxiety and even personality disorders in many people," the article contends.

Chemotherapy on its own, it continues, is "also tied to high rates of psychiatric disorders, whereas 'kinase inhibitors' — targeted drugs that often have fewer side effects — had the lowest rates."

Dr. Lai wonders "whether patients are given enough opportunities to weigh the psychological risks of potential treatments," the story states. She's quoted as maintaining that "it would be useful for cancer patients who are newly diagnosed to see what the data tell us and make an informed decision."

Testicular cancer "carried a higher risk of depression than any other cancer type, affecting 98 of every 100 patients," according to her study, an unexpected result.  

Dr. Nathalie Moise, professor of medicine at Columbia University's Vegelos College of Physicians and Surgeons, suggests that while "current treatment guidelines suggest screening for depression as part of routine cancer care," these findings "may support the need to also screen for suicide and other risk factors."

More on the mental state of patients can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Saturday, March 19, 2022

Physician who had skin cancer himself gives several suggestions for preventing the disease

Despite the fact that most skin cancer is preventable, and usually curable if caught early, the cancer remains the most prevalent — with more cases diagnosed each year than all other cancers combined.

Dr. Gerald L. Saliman
That, at least, is the opinion of Dr. Gerald L. Saliman, an internist who retired from Kaiser San Francisco, where he was chief of patient education. 

In a recent column for a special Senior Life section of J. the Jewish News of Northern California, "Jerry" Saliman quotes dermatologist Dr. Jennifer C. Haley, associate professor at UCLA, to that effect — and emphasizes that risks are dependent on how much sun to which you've been exposed.

Saliman himself had a melanoma, and his wife "has had basal cell carcinoma and shamus cell carcinoma," his article reveals.

"Clouds block only 20% of UV radiation," he writes, "so it's important to wear sunscreen even if it's cloudy."

In addition, he suggests that everyone check their skin "regularly for odd spots or sores that do not seem to heal, particularly in areas that are exposed to the sun."

He notes that he "promptly went to see my doctor when I noticed a tiny, funny-looking skin lesion, and I am glad I did so."

Years after his surgery, he's still cancer-free.

His cancer, the article indicates, was on his left temple, "most likely…because I had frequent sunburns as a child, and our car's side windows did not protect me from UV radiation." 

Saliman's recommendations to prevent cancer of the skin, "the largest organ in the human body," include staying out of the sun from 10 a.m. to 4 p.m., "wear sun-protective clothing, including a wide-brimmed hat, long sleeves and long pants."

More about disease preventives can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Saturday, March 5, 2022

Many physicians now favoring multiple options other than chemotherapy to treat cancers

A growing number of cancer patients, especially those with breast and lung malignancies, are being spared chemo in favor of other options.

At least that's the conclusion of The New York Times.

According to a recent story by the paper's most prolific cancer specialist, Gina Kolata, because "there is a growing willingness among oncologists to scale back unhelpful treatments" and because genetic tests "can now reveal whether chemotherapy would be beneficial," there are many better options for patients than chemo.

Among them, the article notes, are "an ever-expanding array of drugs, including estrogen blockers and drugs that destroy cancers by attacking specific proteins on the surface of tumors."

These alternative treatments, the piece notes, are increasingly being used for breast and lung cancers, and many others as well, sparing "thousands each year from the dread chemotherapy treatment, with its accompanying hair loss, nausea, fatigue, and potential to cause permanent damage to the heart and to nerves in the hands and feet."

And even when chemo is indicated, Kolata's story says, "doctors often give fewer drugs for less time."

Dr. Lisa Carey
"It's a totally different world," the article quotes Dr. Lisa Carey, breast cancer specialist at the University of North Carolina.

That view is supported by Dr. Robert Vonderheide, lung cancer specialist who heads the University of Pennsylvania's Abramson Cancer Center, who says that docs used to discuss whether to give patients two different types of chemo or three but now "are walking in to see even patients with advanced lung cancer and telling them, 'No chemo.'"

Kolata's piece calls the change "a quiet revolution" that has stemmed from "a slow chipping away" at the number of people for whom chemo — which for decades was considered "the rule, the dogma" — is recommended.

More information on new therapies can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.