Challenges in Identifying Suicide Risk in Oncology Care: Implications for Nursing Practice Based on Two Case Reports

Area of Science:

• Oncology Nursing
• Psychosocial Oncology
• Suicide Prevention

Background:

• Cancer patients face elevated suicide risk compared to the general population.
• Subtle psychological distress, intertwined with physical and existential suffering, complicates recognition of suicidality in oncology settings.

Purpose of the Study:

• To explore challenges in recognizing suicide risk among oncology patients.
• To identify nursing-relevant learning points through forensic case reports.

Main Methods:

• Qualitative case report analyzing two male cancer patients who died by suicide.
• Data collected retrospectively from autopsy reports, medical/nursing records, and interviews.
• Thematic analysis focused on psychosocial context, communication, and care trajectories.

Main Results:

• Suicidality presented differently: one patient showed visible distress and impulsivity, the other planned suicide with emotional restraint.
• Distress was linked to illness decline and existential burden.
• Opportunities for psychosocial assessment and intervention were limited in both cases.

Conclusions:

• Highlights the need for psychosocial awareness and sensitive communication in oncology care.
• Emphasizes holistic nursing assessment for patients with functional decline and dignity-related distress.
• Nurses should explore existential distress and engage in direct conversations about suffering to facilitate support and referral.