Killing Diagnoses…

29. April 2010

Perhaps urologists should be even more gently with the prostate cancer diagnosis: As early as two days after receipt of the bad news, patients conspicuously frequently decide to commit suicide - or have a fatal heart attack within one year.

Ever since its publication, the „Focus Report 1” regarding the “epidemiology of prostate cancer in the Muenster area” in 2006, published by the epidemiological cancer registration Northrhine-Westfalia/Germany, it has become an important medical reading matter. Divided into tumor stage and –type and displayed in complex diagrams the reader sees the survival rate of the affected men. After all: About 80 percent of the cancer patients are still alive five years after the initial diagnosis.

But what applies for Muenster and seems to be applicable for entire Germany does not turn out leniently for all of them. Because sometimes men decided only few days or months after the diagnosis to commit suicide or die due to the extreme pressure from a heart attack – as confirmed by a recent study if the “Journal of the National Cancer Institute”. This study managed by Fang Fang at the Harvard Medical School Boston is based on more than 340,000 patient data of the American cancer register and covers a period from 1978 to 2004. It came as a surprise to Fang that 6,845 men died mainly during the first three months after diagnosis by cardiovascular death, 148 prostate cancer patients committed suicide.

Difference more than significant

Those numbers themselves would have little significance – because whether the patients in San Francisco, Detroit or Seattle or any where else bring their lives to an end or the decision was connected to the tumor findings – Fang could not determine that in retrospective. For that he used the suicide statistics of the same period and from there the expected number of suicides. According to that it should have been 105 men of the studied cohort choosing suicide and not 148 – in relation to the extremely high total number of patients the difference is statistically more than significant. Medical professionals report for quite a while now that a cancer diagnosis might entail suicide. For example researchers at the University of Washington published a study in 2008 which examined suicide rates of more than two million patients. Alarming results: The suicide rate was double compared to the general population. Most of all men with stomach- or lung cancer and head tumors decided for the fast way out: Suicide.

Wife and child help to survive

Since – next to suicide – cardiovascular deaths seem to play a role, which physicians now consider a by far more significant connection between primary disease and secondary factors like anxieties and other extreme psychological stress. Fang says that it is accordingly explainable that men in stable family situations suffer from cardiovascular death considerably less – wife and children turn out to be a survival aid.

In addition to care and love of the own family, molecular medicine prolongs life. Fang writes that the heart death rate decreased after implementation of the PSA-tests. The diagnoses were received as more ‘soft’ thus decreasing the stress of the patient.

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