Bring someone when receiving a serious diagnosis and postpone major decisions unrelated to treatment
Swedish data found suicide risk 12.6 times higher and cardiovascular mortality 5.6 times higher during the first week after a cancer diagnosis than among people without that diagnosis. The suicide association was 3.1-fold over the first year and greater for cancers with poorer prognosis. Actual events remained uncommon. Bring support when collecting results, arrange contact afterward, and let decisions such as resigning or selling a home wait until you have had time and another clinical discussion.
What it takes
Nothing to arrange company. Delay non-treatment decisions for a few days where possible.
What you may gain
A Swedish nationwide cohort included 6,073,240 people followed during 1991–2006. Compared with people without a cancer diagnosis, first-week suicide RR was 12.6, 95% CI 8.6–17.8, with an incidence rate of 2.50 per 1,000 person-years. Over the first year, RR was 3.1, 95% CI 2.7–3.5, with a rate of 0.60 per 1,000 person-years. Cardiovascular mortality RR was 5.6 during the first week, 95% CI 5.2–5.9, rate 116.80 per 1,000 person-years; during the first four weeks, RR was 3.3, 95% CI 3.1–3.4, rate 65.81 per 1,000 person-years. The excess declined rapidly during the first year and was more pronounced for poorer-prognosis cancers. A within-patient comparison of different periods gave consistent results.
Context & considerations
These are cancer data; the source did not find equally strong evidence for every other serious diagnosis. The first-week rate of 2.50 per 1,000 person-years is an annualized rate, not 2.5 deaths per 1,000 people during that single week. The point is to support someone during the immediate shock, not to suggest an event is likely. For ongoing care, reimbursement, and follow-up, see chapter 16 and chapter 24. If nobody can accompany you, see entry 6.
Research & references
Fang F et al. (2012). Suicide and cardiovascular death after a cancer diagnosis. New England Journal of Medicine. https://doi.org/10.1056/NEJMoa1110307