Cancer diagnosis in people with mental illness

[making_art]

Cancer diagnosis in people with severe mental illness: practical and ethical issues
Lancet Oncology (August 2010), 11 (8), pg. 797-804

Summary

There has been increasing recognition of the high physical morbidity in patients with severe mental illness, but little has been written about cancer in these patients. Therefore, we review the published work on risk of cancer in patients with severe mental illness, treatment challenges, and ethical issues. Severe mental illness is associated with behaviours that predispose an individual to an increased risk of some cancers, including lung and breast cancer, although lower rates of other cancers are reported in this population. Severe mental illness is also associated with disparities in screening for cancer and with higher case-fatality rates. This higher rate is partly due to the specific challenges of treating these patients, including medical comorbidity, drug interactions, lack of capacity, and difficulties in coping with the treatment regimen as a result of psychiatric symptoms. To ensure that patients with severe mental illness receive effective treatment, inequalities in care need to be addressed by all health-care professionals involved, including those from mental health services and the surgical and oncology teams.

 

[Daniel E.]

Re: Cancer diagnosis in people with severe mental illness: practical and ethical issu

although lower rates of other cancers are reported in this population

And there may be genetic reasons for that:

Why People With Schizophrenia Have Lower Rates Of Cancer: New Clues

New studies clarify the evidence of a genetic link between schizophrenia and cancer, providing a surprising possible scientific explanation for lower rates of cancer among patients with schizophrenia -- despite having poor diets and high rates of smoking -- and their parents.

www.sciencedaily.com

 

[making_art]

Re: Cancer diagnosis in people with severe mental illness: practical and ethical issu

Cancer death rate 65% higher among the mentally ill
Andre Picard, Globe and Mail
Jan. 13, 2009

People suffering from mental illness have a death rate from cancer that is 65 per cent higher than others in the general population, according to new Canadian research. And the higher mortality rate exists even though those with mental illness are not significantly more likely to develop cancer, the research team found. While the data do not explain why the death rate is so much higher, researchers believe the most likely culprit is stigma: that health professionals are failing to see beyond mental health to diagnose physical ailments in a timely manner, even grave ones such as cancer.

People suffering from mental illness have a death rate from cancer that is 65 per cent higher than others in the general population, according to new Canadian research. And the higher mortality rate exists even though those with mental illness are not significantly more likely to develop cancer, the research team found. While the data do not explain why the death rate is so much higher, researchers believe the most likely culprit is stigma: that health professionals are failing to see beyond mental health to diagnose physical ailments in a timely manner, even grave ones such as cancer.

"The results are shocking," Joseph Sadek, a psychiatrist at Dalhousie University and co-author of the research, said in an interview. "Stigma is still a very big problem. It interferes with the doctor-patient relationship and with care," he said. The research, published in the Canadian Journal of Psychiatry, was designed to examine the link between mental illness and cancer. Much has been published on the topic, but the research is often contradictory.

The existence of a universal health-care system and province-wide databases, however, allows for such studies to be done on a massive scale in Canada. In this case, researchers compared the records of patients treated for mental health problems in Nova Scotia from 1995 to 2001 with those treated for cancer in the same period.

There were almost 247,344 people treated for mental health problems in the province during that time, about one in four residents. Of that total, 4,690 were diagnosed with cancer. On the whole, cancer incidence rates were about the same among mental health patients and those in the general population. There was, however, significantly more lung cancer and more brain cancer among mental health patients.

Dr. Sadek said that, at the outset, researchers expected to see far more cancer in psychiatric patients than in the general population, in large part because many live in poverty and make poor lifestyle choices, such as smoking. What they did not expect was the dramatically higher mortality rates among mental health patients - 72 per cent in men and 59 per cent in women - who have the same risk of dying as everyone else.

"The real question to emerge from this research is: Why are people dying?" Dr. Sadek said.

He said that in Canada's universal health-care system, everyone should have the same access to care, at least in theory. But researchers believe that people with mental health problems who develop cancer are less likely to be screened and diagnosed, and are more likely to experience delayed treatment. "This is a population that doesn't complain much about their physical ailments. They have other problems," Dr. Sadek said.

He said the research results should serve as a message to physicians to make extra efforts to probe the physical health of their mental health patients. About three million Canadians suffer from mental health problems at any given time.

 

[Daniel E.]

People with mental illness less likely to get cancer screening - Reuters

In a review of 47 previous studies covering 4.7 million people in 10 countries, the study team found that adults with mental health issues were 24% less likely overall to get screened for cancer compared with the general population.

The disparities were greatest among women with schizophrenia, who were roughly half as likely as women in the general population to be screened for breast cancer.

 

[Daniel E.]

My local hospital has an outreach program just for lung cancer screening.

From the American Lung Association:

Saved By The Scan

If you smoked, this new low-dose CT lung cancer screening test and eligibility quiz could save your life.

www.lung.org

Lung cancer is the leading cause of cancer deaths in America, but now there's hope. Screening is used to detect lung cancer early, when it is more likely to be curable. If lung cancer is caught before it spreads, the likelihood of surviving 5 years or more improves to 60 percent.*

A low-dose CT scan is a special kind of X-ray that takes multiple pictures as you lie on a table that slides in and out of the machine.

If you're a current or former smoker over the age of 50, you could meet the high-risk eligibility criteria.

Lung Cancer Risk Quiz

Find out if you might be at risk for lung cancer and qualify for a lung cancer scan by taking our screening eligibility quiz.

www.lung.org

Thanks to the latest advances in medical technology, there is new hope for patients and families at risk for lung cancer. Our screening eligibility quiz will let you know if you should talk to your doctor about being screened for lung cancer via low-dose CT scan. Screening is key to early detection — when lung cancer is diagnosed at an early stage it is more likely to be curable.

 

[Daniel E.]

March is Colon Cancer Awareness Month: Get tested no later than age 45

March is Colon Cancer Awareness Month Liz Dunphy, DNP, CRNP, OncoLink Cancer Blogs March 11, 2021 About a year ago, a friend of mine who just turned fifty went for her screening colonoscopy and was found to have an early stage colon cancer requiring surgery. She was understandably upset when...

forum.psychlinks.ca

The American Cancer Society (ACS) changed their recommendation to start colon cancer screening at age 45 in 2018 which had previously been to start at age 50. The ACS made changes because data showed there was a rising incidence of colorectal cancer being diagnosed in younger and middle-aged patients.

 

[Daniel E.]

Patterns of tobacco-related mortality among individuals diagnosed with schizophrenia, bipolar disorder, or depression (2014)

Tobacco-related conditions comprised approximately 53% (23,620/44,469) of total deaths in the schizophrenia, 48% (6004/12,564) in the bipolar, and 50% (35,729/71,058) in the depression cohorts...

The integration of smoking cessation treatments into psychiatric care likely has been limited by institutional barriers (e.g., staff training, funding for cessation treatments for smoking, organizational climate), the common misbelief that psychiatric patients do not want to quit smoking, and that their condition may be aggravated by quitting smoking (Hall and Prochaska, 2009, Schroeder and Morris, 2010). However, recent research has demonstrated that approximately 20% of psychiatric patients report being in the preparation stage—that is, having made at least one 24-h quit attempt in the last year and having a plan quit smoking in the next 30 days (Hall and Prochaska, 2009)—and that patients' psychiatric conditions do not appear to be aggravated with smoking cessation (Hall and Prochaska, 2009, Banham and Gilbody, 2010).

In addition, reviews and current meta-analyses have found that standard smoking cessation interventions (i.e., individual and/or group therapy, nicotine replacement therapy, bupropion) generally work as well in psychiatric populations as in the general population (Banham and Gilbody, 2010, El-Guebaly et al., 2002). Also recent clinical studies and reviews have recommended the implementation of tailored smoking-cessation interventions (with appropriate clinical treatment of the comorbid psychiatric condition) for individuals diagnosed with schizophrenia (Morden et al., 2012, Tsoi et al., 2010), bipolar disorder (Weinberger et al., 2008, George et al., 2012, Wu et al., 2012, Weiner et al., 2011), and depression (Gierisch et al, 2012).

 

[David Baxter PhD]

March is Colon Cancer Awareness Month: Get tested no later than age 45

March is Colon Cancer Awareness Month Liz Dunphy, DNP, CRNP, OncoLink Cancer Blogs March 11, 2021 About a year ago, a friend of mine who just turned fifty went for her screening colonoscopy and was found to have an early stage colon cancer requiring surgery. She was understandably upset when...

forum.psychlinks.ca

The American Cancer Society (ACS) changed their recommendation to start colon cancer screening at age 45 in 2018 which had previously been to start at age 50. The ACS made changes because data showed there was a rising incidence of colorectal cancer being diagnosed in younger and middle-aged patients.

Note that the recommendation is no later than 45. If there's any family history of cancer, get it done sooner rather than later.

My younger brother was diagnosed with stage 4 colon cancer at age 50. I don't know if he'd ever had a colonoscopy but 50 was the recommended age for starting colonoscopies then. He didn't make it to 51 before it took his life.

I get that people want to postpone colonoscopies as long as possible. It's really only the "cleansing preparation" that's somewhat daunting; once that's done, you get a sedative and drift away and when you wake up it's all done. What discomfort there may be is nothing compared to the ongoing discomfort and pain of being treated for colon cancer. If you're in your 40s and have not yet had your first colonoscopy, just call your doctor and get it done: if you do have cancer, the earlier you find out the better your chances for successful treatment. Don't put it off any longer. Just do it.

By the way, another thing that's occurring at progressively younger ages is cataracts - too much time in the sun without adequate sunglasses.