Schizophrenia is a mental illness that affects a person’s ability to think clearly and separate fact from fiction. It may only affect about 1.2 percent of Americans (about one percent of Americans are actually diagnosed), but that’s still about 3.2 million people (not to mention their friends and families) who are affected by this disease and the things that come along with it.
In several studies, schizophrenia has been linked to a roughly 50 percent increase in the chance of developing breast cancer, along with a 300 percent spike in the chance of developing colon cancer. Researchers have not yet discovered the cause of the correlation between the two diseases, but it remains a troubling one.
A schizophrenia diagnosis has far-reaching implications that go beyond a simple increase in the likelihood of developing breast cancer, however. If a woman with schizophrenia does develop cancer, her experience will be much different than that of the average woman.
People with schizophrenia are often suspicious of doctors, meaning they’re less likely to cooperate with the tests that will determine whether they have cancer. And that means many cases of breast cancer in women with schizophrenia are not found until later than normal, if at all. Caretakers and family members of people with schizophrenia are also likely to let their health and regular check-ups fall to the wayside as they deal with the stress of a loved one with a mental illness.
If diagnosed with breast cancer, women with schizophrenia are also more likely to be non-compliant with the treatment plans recommended by doctors. They often struggle to understand the gravity of the situation and simply brush off the diagnosis, convinced their health care team does not have their best interest in mind.
In an effort to improve the sad statistics, a team of researchers set out to determine the best treatment option for women with breast cancer and schizophrenia. The “right” treatment would have to take into account both the cancer and the woman’s potential resistance to treatment.
The answer they came up was that initial radical mastectomy without adjuvant radiation therapy is probably the best method of treatment for people with schizophrenia. It involves performing only one procedure that the patient has to consent to, reducing the risk of non-compliance, and it removes all of the breast tissue, meaning it offers a very low rate of breast cancer recurrence. Since recurring cancer would mean the patient would need to consent to more procedures—and since the patient may not comply with the post-cancer screening and testing recommendations that would help diagnose a second occurrence of cancer—a total removal of the breast tissue and surrounding tissues may be best to guarantee a high long-term survival rate in patients with schizophrenia.
We’d like to stress that every treatment decision should be made on a case-by-case basis. But it is certainly important for doctors to consider their patients’ state of mind when recommending a certain test or treatment, and schizophrenia is a huge part of that. A patient’s willingness to comply has as much effect on her probability of survival as choosing the most effective treatment does.
While this information may not affect many of us, it is important for doctors and loved ones of people with schizophrenia to be aware of the implications of the disease on the person’s breast cancer risk and willingness to comply with treatment. A person who exhibits schizophrenic symptoms needs to be treated with specialized care and understanding; it could save their life.
Elizabeth Nelson is a wordsmith, an alumna of Aquinas College in Grand Rapids, a four-leaf-clover finder, and a grammar connoisseur. She has lived in west Michigan since age four but loves to travel to new (and old) places. In her free time, she. . . wait, what’s free time?