Suicide and cancer: Where do we go from here?

Although suicide in cancer patients is a burdening public health problem with ethical, medical and psychiatric implications, it still has to be clarified why cancer patients commit suicide and how cancer suicides differ from others. Therefore, a review of the literature on suicide and suicidal ideation in cancer patients was conducted, starting from an overview of these issues in the general population. Evidence suggests that suicidality in the general population can be explained according to a genetic and psychological vulnerability to stress. The psychological and physical stressors found to be associated with suicide in cancer patients corroborate this model. Nevertheless, based on the well-described immunological disturbances due to cancer, we propose that suicide is not just a secondary reaction to cancer but is linked to an intrinsic bio-psychological vulnerability to distress. Upcoming studies should better characterize the neurobiology of suicidality in cancer, opening new avenues for treatment and prevention.