Among all cancer survivors, male adolescents and young adults have the highest rate of death by suicide.

Matsuo K, Duval CJ, Nanton BA, et al. Suicide Deaths Among Adolescent and Young Adult Patients With Cancer. JAMA Network Open. 2024;7(11):e2442964.

 

Research published in JAMA Network Open found that the number of deaths by suicide among adolescent and young adult male cancer survivors aged 15 to 39 increased three-fold over a 21-year period.

“Because this study noted that many suicide deaths among these AYA patients with cancer occur years after the cancer diagnosis, long-term care and support for cancer survivors is recommended.”

The researchers examined data from the National Cancer Institute Surveillance, Epidemiology, and End Results Program. They analyzed just under 4.5 million suicide deaths among AYA patients between 2000 and 2021.

They defined a cancer survivor as any person who had ever received a diagnosis of cancer, regardless of the progression of their disease.

 

Suicide rates triple in 21-year period

 

The researchers determined that in 2000, there were 4.9 deaths per 1,000 among male adolescent and young adults who had survived cancer but died by suicide.

For other age and gender groups, the suicide rates ranged from 0.4 to 3.1 per 1,000.

By 2021, the number of deaths by suicide among young adult and adolescent male cancer survivors had increased significantly to 15.4 deaths per 1,000.

Wael Harb, MD, a board-certified hematologist and medical oncologist at MemorialCare Cancer Institute at Orange Coast and Saddleback Medical Centers in Orange County, CA, says the findings of the study are worrying.

“The findings are deeply concerning but not entirely surprising. Male AYA cancer survivors face unique psychosocial and physical challenges that are often overlooked. Their increased vulnerability stems from societal expectations of masculinity, limited peer support, and the life-altering impact of cancer at such a formative stage in life. While the magnitude of the suicide rates is shocking, it highlights the critical need for targeted mental health interventions for this group,” he tells MDlinx.

“A three-fold increase over 2 decades points to significant gaps in survivorship care. It highlights systemic failures to address the psychological and emotional well-being of young male cancer survivors. This trend calls for urgent action to integrate mental health support into long-term survivorship care plans.”

 

Challenges faced by young male cancer survivors

 

Dr. Harb says that young male cancer survivors may face a variety of challenges. Physically, they may experience long-term side effects including infertility, fatigue, physical disfigurements from treatment, hormonal imbalances, and chronic pain.

Socially, they may struggle with disruptions to career, education, or relationships, and have trouble reintegrating into normal life.

They may also experience problems related to their identity, including issues with self-esteem and body image and a loss of independence.

Shane Owens, PhD, a board-certified behavioral and cognitive psychologist, says that those with cancer also experience numerous factors that may increase their risk of suicide.

“In addition, there is evidence to indicate that men of all ages are likely to have a blunted ability to express many emotions that society considers negative.”

The researchers found that testicular cancer, thyroid cancer, and melanomas of the skin are the most common cancer diagnoses that lead to suicide among adolescent and young adult cancer patients.

Matsuo K, Duval CJ, Nanton BA, et al. Suicide Deaths Among Adolescent and Young Adult Patients With Cancer. JAMA Network Open. 2024;7(11):e2442964.

These three cancers are also among those with the highest 5-year survival rates.

 

 

Survival is only the first step

 

Dr. Harb says that surviving cancer is only just the beginning.

“Survival is only the first step. Quality of life after cancer is equally critical as survivors often face ongoing physical, emotional, and social challenges. A holistic treatment plan that incorporates survivorship care ensures [that] patients have the resources they need to reintegrate into life and thrive beyond their diagnosis,” he says.

The study authors recommend that young cancer patients be given more long-term support to address the rates of suicide.

Dr. Owens argues that from the moment of diagnosis, mental healthcare should be considered alongside cancer treatment.

“All medical care should be fully integrated with mental health. Someone with mental health training should be immediately available at the point a cancer diagnosis is considered,” he says.

“While the ongoing involvement of mental health professionals will be shaped by the patient, his prognosis and course of treatment, and his family, waiting for tests to confirm a diagnosis and treatment plan unnecessarily delays healthy coping. Healthy coping begins immediately when cancer is possible.”