The results of a large-scale study of patients recently published in the "Annals of the American Thoracic Society," suggests that palliative care is associated with a reduced risk of suicide among veterans diagnosed with lung cancer at an early stage. The conclusions were based on a study of over 20 000 patients with lung cancer registered in the register of patients with cancer in the Central Register of cancer.
Donald Sullivan, doctor, associate professor of medicine (pulmonary and critical medicine) in the OHSU School of Medicine and principal investigator of the Center for the Advancement of veterans participating in medical care in the health system in the Portland Veterans lead author. He said that the purpose of the study was to find out whether palliative care aimed at the relief of physical pain and discomfort, and the decision of psychological problems such as anxiety, which reduces the quality of life for people with life-threatening illnesses, reduces the rate of suicide veterans with stage IIIB and IV lung cancer.
Of the 20 900 patients with advanced lung cancer registered in the Registry, 30 patients had committed suicide, more than five times higher than the average of all the veterans who use medical services of the same age and sex. However, the data showed that patients with lung cancer who have had at least one visit to palliative care after their diagnosis, 81 percent less risk of suicide.
Sullivan says that the psychological impact of a diagnosis of cancer, particularly lung cancer diagnosis, underrated and largely overlooked in the medical community.
"Suicide is an important public health problem, especially among patients with lung cancer and among veterans," - said Sullivan, who is also a member of the Institute of OHSU ovarian cancer. "As a result of the existence of effects such as social isolation, depression, anxiety, can remain undiagnosed and untreated."
Sullivan believes that this is the first study to examine the relationship between palliative care and suicide risk in cancer patients. According to Sullivan, several medical societies recommend palliative care to all patients with advanced lung cancer, but there is often a gap between guidelines and practice.
"There are many barriers to palliative care, and, unfortunately, some of them related to the direction of clinicians," - he says. "Not all doctors are aware of the benefits of palliative care."
Sullivan believes that palliative care should be offered to all patients soon after diagnosis of lung cancer with advanced. According to him, the best scenario - a comprehensive approach, in which patients with serious illnesses receive palliative care at the same time they receive other treatments, such as chemotherapy.
Sullivan said that it is important that clinicians treating patients with lung cancer, to be vigilant in recognizing the presence of one or more other diseases or disorders, such as mental illness kobmorbida, their patients and become familiar with local resources.
"For patients and families it is important to understand that these risks exist, and not be afraid to contact your ISP for help", - he says.
This study was the analysis, explains Sullivan, and further research is required a very large number of patients, given the overall likelihood of suicide. In short, a randomized trial of this scale would be a difficult task, he said, and one that will require many years to complete.
This time it is not in some patients.
"We really can not afford to wait for more data," - he says. "I would like to see greater efforts to screening and treatment of concomitant psychological disorders among patients with lung cancer, for which there is good evidence. I also believe that we need more efforts to integrate palliative care earlier in the paradigm of the treatment of lung cancer. "