Two recent studies show that the link between cancer survival and suicide is greater than previously believed. Not only do survivors suffer from depression, sadness, distress and grief, some survivors also face physical disfigurement and crushing debt that leads to a feeling of hopelessness.

One study looked at gender differences among cancer survivors who committed suicide. Using data from 2000 to 2014, it found that male cancer survivors older than 70 were 2.5 times more likely to commit suicide than male survivors who were 20 to 39 years old.

However, the study found the opposite with female cancer survivors – suicide among those age 20 to 39 was double that of those older than 70. One study author commented that if women of child-bearing age are more likely to commit suicide, then that’s something the patient’s support group can look out for.

‘The cancer of the lonely’

Meanwhile, another study found that suicide among patients in recovery for head and neck cancers is twice that of other cancer survivors. One expert called it “the cancer of the lonely,” citing the disfigurement and isolation suffered by these cancer survivors.

Citing the fact that treating head and neck cancer can cost nearly $80,000 in the first year after diagnosis, the researchers also cited massive debt as being a cause of the increase in suicide. Since many head and neck cancer survivors can’t return to work because they are functionally disabled, the isolation and financial strain becomes worse.

Screen for suicidal ideation

One expert suggests screening for suicidal ideation at pivotal moments during treatment, such as at the point of diagnosis or if treatment doesn’t show effectiveness.

Given the nature of the disease, it’s not unusual for cancer patients to have suicidal thoughts, the expert said, and when patients or survivors are hit with disfigurement or debt, the issue can be much worse.

Community and connection is key to survival. Married cancer survivors are statistically less likely to commit suicide than single survivors, experts say.

If you or someone you know is in danger of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 for 24-hour support.