Newly diagnosed cancer patients have an increased risk of suicide and death from heart attack and stroke, according to a new study.

Research published this week in The New England Journal of Medicine finds that the risk is present even before treatment begins, and the risk was greatest among people with the most deadly cancers.

The findings confirm that a cancer diagnosis may have an immediate affect on physical and emotional health that can lead to death, say researcher Unnur Valdimarsdottir, PhD, of the University of Iceland in Reykjavik.

"Just as war and natural disasters have been linked to deadly cardiovascular events and suicide, a diagnosis of cancer is a major life stressor," Valdimarsdottir tells WebMD.

Cancer Diagnosis and Noncancer Death

The study included data from 1991 to 2006 about 6 million adult residents of Sweden age 30 or older who were enrolled in a nationwide health registry.

During this time, about 534,000 people in the registry received a first diagnosis of cancer. Slightly more than 26,300 people were diagnosed with cancers considered to be highly fatal, including those of the esophagus, pancreas, and liver.

Compared to people without a diagnosis of cancer:

• People with cancer were 12 times more likely to commit suicide within a week of diagnosis and three times more likely to commit suicide within a year.
• Cancer patients had a fivefold increase in deaths due to heart attack, stroke, or blood clots in the week following their diagnosis. In the first month following their diagnosis they had a threefold increase in risk, compared to people without cancer.
• People with the most deadly cancers had a 16-fold greater suicide risk within a week of diagnosis and a 15-fold greater risk of having a fatal heart attack or stroke.

Within a year of diagnosis, the suicide, heart attack, stroke, and blood clot-related death risk had returned to normal levels for people with all types of cancer.

Message: Address Noncancer Needs

Psychiatrist Bryan Bruno, MD, of Lenox Hill Hospital in New York City, says the findings highlight the need to address emotional and noncancer-related health issues in the weeks following a diagnosis of cancer.

"This is especially true for patients with a history of psychiatric illness or established heart disease," he tells WebMD. "Often the oncology team is focused on the cancer alone and the psychological needs of the patient may not be addressed."

He says it is not uncommon for patients with a new diagnosis of cancer to stop taking the drugs that reduce their risk for heart disease and other chronic conditions.

American Cancer Society Deputy Chief Medical Officer Len Lichtenfeld, MD, agrees that the study shows the importance of remaining vigilant for signs of depression and deteriorating health in newly diagnosed cancer patients, even though it is not clear if the findings from the Swedish study directly apply to patients in the U.S.

"There is a tendency to dismiss depression in newly diagnosed patients, but just like the cancer itself, it can be very serious and must be addressed," he says.

SOURCES:Fang, F. New England Journal of Medicine, April 5, 2012.Unnur Valdimarsdottir, PhD, Center for Public Health Sciences, University of Iceland, Reykjavik, Iceland.Bryan Bruno, acting chairman, department of psychiatry, Lenox Hill Hospital, New York.Len Lichtenfeld, MD, deputy chief medical officer, American Cancer Society.

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