An overview of mental health impacts on women diagnosed with gynecologic cancer and suicide prevention

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This article was exclusively written for The European Sting by Ms. Sara Araújo de Medeiros Mendes is a first year medical student at UNICEPLAC (Centro Universitário do Planalto Central Apparecido dos Santos). She is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

Suicide is currently considered a public health problem in Brazil and worldwide (WHO, 2017). Suicidal behavior is multifactorial, including: suicide ideation, planning, suicide attempts and consummation (RODRÍGUEZ-CINTAS et al, 2017). Studies show that prevention against suicidal ideation is the best strategy to fight this problem, and that the association of physical and mental illness can contribute negatively to depression and the risk of suicide.

In this degree, several studies have pointed to a higher risk of suicide in patients with serious diseases. The diagnosis of cancer, in particular, has led individuals to an increased rate of depression and the risk of suicide. Studies found that the average incidence of psychiatric disorders can reach up to 40% of cancer patients, with depression and suicidal thoughts being the main characteristics (CONSTANTINI et al., 2014). Furthermore, when referring to depression, recent studies indicate that 15% to 20% of cancer patients have symptoms associated with depressive disorder, and often manifest in symptoms related to pain, fatigue and physical limitations caused by the disease.

Moreover, there are also variations among cancer patients: patients with certain cancer types are at much higher risk for suicide. Women diagnosed with gynecological cancer, especially in later stages of the disease – requiring multimodal treatment (chemotherapy, radiotherapy and surgery) – are the most affected according to research (KLUGEL et al, 2017). In this context, there are a number of factors that may contribute to this reality: sexual inactivity or loss of sex drive, and often the frustration of eventual infertility. In addition to the severity of the disease, there are social and psychological factors that contribute to women with gynecologic cancer having a greater predisposition to disorders associated with depression. Therefore, there is an issue that needs further attention from mental health policies: Women with a diagnosis of gynecological cancer are extremely vulnerable to psychiatric illness, depression, and suicidal ideation.

Given these points, it is evident that public health departments must develop an intervention program to support women with gynecological cancer in more advanced stages and promote special attention to their mental health, besides physical health. The proposal consists in the creation of support work forces with multidisciplinary teams composed of psychologists, nurses, social workers and doctors, who can contribute positively to the prevention of depression and suicidal ideation in these patients. It is essential that the prevention program also embraces the family members of the patients, especially those who follow the treatment and make up a family support network. It is important to consider the fact that family members are also emotionally empowered to contribute positively to the patient recovery and prevention of depression and suicidal ideation.

References

Costantini, A., Pompili, M., Innamorati, M., Zezza, M. C., Di Carlo, A., Sher, L., & Girardi, P. Psychiatric pathology and suicide risk in patients with cancer. JournalofPsychosocialOncology, 32(4), 383-395, 2014.

Klügel, S., Lücke, C., Meta, A., Schild-Suhren, M., Malik, E., Philipsen, A., & Müller, H. H. Concomitant psychiatric symptoms and impaired quality of life in women with cervical cancer: a critical review. International Journal of Women’s Health, 9, 795–805, 2017.

Rodríguez-Cintas, L. et al. (2017). Factors associated with lifetime suicidal ideation and suicide attempts in outpatients with substance use disorders. Psychiatry Research, S0165-1781(17) 30426-2

World Health Organization (WHO). Disease and injury country mortality estimates, 2000–2015 [Data files]. Retrieved September 23, 2017 from http://www.who.int/healthinfo/global_burden_disease/estimates/en/index1.%20html

About the author

Sara Araújo de Medeiros Mendes is a first year medical student at
UNICEPLAC (Centro Universitário do Planalto Central Apparecido dos Santos). She
enjoys engaging in various academic activities such as congress organization,
academic league boarding, drafting and presentation of works and is fascinated by
the scope of teaching and research. In addition, she is constantly volunteering and
working with organizations and activities aimed at serving and assisting marginalized
populations, as she seeks to become a more humanized professional and citizen.