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Debt, disfigurement place survivors of these types of cancer at higher risk of suicide

A microscopic view of oral cancer.
Wikimedia Commons

Studies show cancer survivors are twice as likely to die by suicide than the general population. But some cancer survivors are at a greater risk than others, according to research from a St. Louis University doctor.

A study appearing in this month’s journal Cancer has found patients in recovery from pancreatic, head and neck cancers die by suicide at a higher rate than other common cancers. In the case of head and neck cancer, the suicide rate is 63 for every 100,000 people — close to four times that of the general population and two times that of other cancer survivors combined.

The findings emphasize a little-talked about subject: the mental health needs of patients after they finish treatment, said Nosayaba Osazuwa-Peters, an assistant professor of otolaryngology at SLU and lead author of the study.

“To imagine that the problem [of suicide] is even more serious among people who we celebrate as survivors, that’s what made the study more profound to me,” he said. “They expect you to be happy, but people may not really understand how you’re feeling inside because the treatment is very toxic.”

Head and neck cancer survivors often carry visible evidence of their illness and its treatment on their faces. Many survivors have difficulty eating, drinking or speaking or live with permanent facial disfigurement.

“We take it for granted, but for a head and neck cancer patient who has had their jaw removed, just a simple sharing of a meal with friends becomes a problem,” Osazuwa-Peters said.

Disfigurement can make other people nervous around cancer survivors, which can lead to more isolation, said Joe Lapides, president of HNC Support International, a California-based nonprofit advocacy and support group for head and neck cancer survivors, patients and their caregivers.

“They call this cancer the cancer of the lonely, “ Lapides said. “The other cancers you can’t always see. Prostate cancer, you don’t know. There’s not physical evidence. This cancer, there’s more physical evidence, that makes people withdraw.”

Many cancer patients carry massive amounts of medical debt, which can make depression among survivors worse. The cost of treating head and neck cancer can be close to $80,000 during the first year after diagnosis. Half of head and neck cancer survivors cannot return to work after the cancer renders them functionally disabled, causing further financial strain.

Ultimately, community and connection is vital for survivors, advocates said. For example, patients who were married were less likely to die by suicide, most likely due to a spouse’s emotional support, Osazuwa-Peters said.

That support is easier to find for some cancer survivors than others, Lapides said.

“Breast cancer, lung cancer, prostate, they’re obviously more prominent,” Lapides said. “We call them the popular cancers. A lot of people don’t know what head and neck cancer is.”

People are finding groups such as HNC International and other national groups through the internet. Lapides says several other support groups have been established since he was diagnosed more than six years ago.

More than any other cancer, it’s important for these particular cancer patients to find support with peers, said Mary Ann Caputo, president of New York-based Support for People With Oral Head and Neck Cancer.

Other survivors can give advice on how to cope with a changed body and social life.

“The support network is vital because they know what they’re going through,” Caputo said. “It’s long-term. With head and neck cancer patients and survivors, it’s importent they find the support they need through other people who have traveled this journey before.”

Follow Sarah on Twitter: @petit_smudge

Sarah is the health reporter at St. Louis Public Radio.

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