Suicide in cancer patients undergoing palliative care: A report of two cases

Introduction. Suicide represents a major public health problem worldwide, and cancer patients might have vulnerability factors which increase suicide risk. There are multiple factors associated with this tragic outcome, including those stemming from the disease itself, mental illness and social, personal and spiritual factors. Although previous reports have identified a suicide rate which ranges from .03-7% among cancer patients undergoing palliative care, this has not been studied in Mexico. Objective. This study sought to report the cases of suicide in patients with cancer undergoing palliative care at a large cancer reference center. Method. A retrospective review of records was performed between 2018-2019 for patients treated at the Palliative Care Service of the Instituto Nacional de Cancerología in Mexico City. Records for patients who committed suicide were reviewed to describe factors associated with this outcome. Results. Among all deaths identified during the record review, two were due to suicide (.09%). The patients were one female and one male, 60 and 42 years of age, diagnosed with breast cancer and gastroesophageal junction cancer, respectively, associated with tobacco and alcohol consumption, as well as several economic, social, and familial stress factors. One of the patients was identified as likely having major depressive disorder. Discussion and conclusion. Deaths might be underreported in our population. A systematic evaluation is required in order to establish and detect suicidal behavior risk factors, and a follow-up plan for all these patients.