Is post-diagnosis suicide risk in cancer patients related to psychological or physical factors?

I have been thinking and learning a lot about suicide risk in cancer patients because I am working with some colleagues in cancer control and prevention to identify and respond to educational needs among cancer care professionals. Related to this topic, readers might be interested a nice article by Kendal & Kendal published last year in the journal Crisis (abstract linked below). This article titled, Comparative Risk Factors for Accidental and Suicidal Death in Cancer Patients makes a number of insightful observations about risk in cancer patients based on statistical analyses of a large and impressive NCI dataset (SEER, 1973-2000).

Among the observations I found most interesting was that the well-documented increased risk of suicide in the year following cancer diagnosis, which is commonly attributed to psychological factors, may in fact be more closely related to physical factors, i.e. rapid deterioration of symptoms in rapidly progressing disease. Because many of the candidate psychological factors were not measured in this study, the question cannot be studied directly, but I found the findings compelling enough–and their treatment in the article careful enough–to warrant consideration. In the end, it may be very difficult to tease apart psychological distress from physical suffering, but I appreciate this article drawing attention to the question.

Citation: Kendal WS & Kendal WM (2012). Comparative risk factors for accidental and suicidal death in cancer patients. Crisis: The Journal of Crisis Intervention and Suicide Prevention. 33(6):325-34. doi: 10.1027/0227-5910/a000149.