New research that now appears in the British Journal of Cancer suggests that a person's history of mental health issues may raise their risk of dying from cancer following diagnosis.
The World Health Organization (WHO) estimate that almost a third of cancer-related deaths are due to modifiable risk factors or behaviors.
These behaviors include not exercising enough, smoking, drinking, or not eating enough fruits and vegetables. However, new research adds another critical factor to the list of things that may influence a person's outlook once they receive a cancer diagnosis: mental health.
Researchers led by Zachary Klaassen, who is an assistant professor and urologic oncologist at the Georgia Cancer Center in Augusta, set out to examine whether a formal psychiatric diagnosis influences cancer survival rates.
Raising cancer death risk by 73 percent
Klaassen and colleagues examined the records of more than 675,000 people who had received a cancer diagnosis. The participants were all adults and received their diagnoses between 1997 and 2014.
Specifically, the study participants had received a diagnosis of one of the 10 most common types of cancer: prostate cancer, breast cancer, lung cancer, kidney cancer, bladder cancer, colorectal cancer, melanoma, endometrial cancer, thyroid cancer, or oral cancer.
Almost 50 percent of these people underwent a psychiatric evaluation as an outpatient, around 7,900 of them received urgent psychiatric help, and over 4,000 were admitted into the hospital because of a mental health problem in the 5 years leading up to their cancer diagnosis.
The study found that the risk of cancer-related death increased along with the level of psychiatric help these people needed and received. More specifically:
- Those who consulted their primary care physician about a mental health issue had a 5 percent higher chance of dying from cancer.
- Those whose mental health problems doctors treated as an emergency were 36 percent more likely to die from cancer.
- Also, being hospitalized for mental health issues raised the likelihood of cancer-related death by 73 percent.
The study was observational, so it cannot establish causality. However, the lead author weighs in on some of the potential mechanisms that may underlie the findings.
Klaassen thinks that the psychological stress that often accompanies mental health conditions can affect the body's natural defense mechanisms. "We think this means mental health may play a larger role in cancer outcomes than previously thought," he says.
"Major depression and stress may affect our body's immune surveillance systems, effectively hampering the ability to detect and fight cancer."
"A recent psychiatric history should be a red flag to all doctors and nurses treating cancer patients," adds Klaassen. "It's essential we keep a close eye on these patients to make sure they're receiving the best possible care and are followed up if and when cancer appointments are missed."
According to the National Institutes of Mental Health, almost 1 in 5 U.S. adults (44.7 million people) are currently living with a mental health condition.