A study by the Medical University of Vienna shows that cancer patients receiving specialised palliative care do not have a higher suicide mortality rate than a comparative group of oncology patients. The findings suggest that interdisciplinary palliative care plays an important role in managing psychosocial and existential stress. The results have recently been published in the Journal of Clinical Medicine.
Cancer is considered a significant risk factor for suicide. Advanced stages of the disease, disease-related symptoms, and coming to terms with the end of life can be particularly distressing. Specialised palliative care focuses precisely on this high-risk group of patients: palliative care provides holistic support for people with serious illnesses by taking psychosocial aspects into account alongside medical treatment. The aim is to maintain and promote the patients’ quality of life as best as possible despite illness-related limitations.
Against this background, a study was conducted to examine the suicide mortality rates of oncology patients in specialised palliative care compared to a control cohort of oncology patients from Austria.
"Our analysis shows that patients with advanced stages of disease in specialised palliative care do not exhibit a higher suicide mortality rate than the general oncological comparison cohort. This underscores the importance of care that specifically addresses psychosocial burdens alongside physical symptoms," says lead author Stephan Listabarth from the Division of Social Psychiatry at the Department of Psychiatry and Psychotherapy at MedUni Vienna.
Comparison with national cohort
For the analysis, patient data from the palliative care unit at MedUni Vienna and University Hospital Vienna (AKH) covering the period from November 2012 to March 2022 were compared with data from the Austrian Cancer Registry and the national death registry. The overall analysis revealed no statistically significant difference in suicide mortality between the palliative care cohort and the comparative oncology group - although this would be expected among seriously ill patients receiving palliative care.
Similarly, in analyses by individual cancer type, no significant differences were observed in most groups. Patients with pancreatic cancer were an exception: in this subgroup, a higher cumulative incidence of suicide was observed in the palliative care cohort. However, the authors emphasise that this finding must be interpreted with caution. For instance, it could be that patients under particularly severe distress are more frequently admitted to specialised palliative care.
"The particular finding of increases in suicide rate in in patients diagnosed with pancreatic cancer requires further investigation. The main aim is to better understand potential risk factors and to further develop targeted support services for patients under particular stress," says study lead Daniel König-Castillo from the Division of Social Psychiatry at the Department of Psychiatry and Psychotherapy at MedUni Vienna.
Holistic end-of-life care
Eva Masel from the Division of Palliative Medicine says: "The results suggest that the interdisciplinary and holistic approach of palliative medicine can make an important contribution. This encompasses not only the treatment of physical symptoms but also psychosocial and spiritual support. This can help to better alleviate burdens such as pain, loss of control, the feeling of being a burden to others, or existential distress."
The authors also emphasise that no causal conclusions can be drawn from the retrospective analysis. The study further highlights the importance of further expanding access to specialised palliative care in Austria. From the authors’ perspective, it is necessary to strengthen the provision of relevant care to meet demand.
The study was conducted at the Division of Social Psychiatry at the Department of Psychiatry and Psychotherapy of the Medical University of Vienna in collaboration with the Division of Palliative Medicine at the Department of Medicine I of the Medical University of Vienna.
Publication: Journal of Clinical Medicine
Suicide Rates Among Patients Receiving Palliative Care-Descriptive Results of a National Cohort Study Stephan Listabarth, Lea Sommer, Armin Trojer, Sabine Weber, Magdalena Grömer, Thomas Waldhoer, Daniel Hackl, Benjamin Vyssoki, Eva Katharina Masel, Matthias Unseld, and Daniel König J. Clin. Med. 2026, 15(6), 2149; https://doi.org/10.3390/jcm15062149
