Supportive Care in Cancer

, Volume 25, Issue 12, pp 3691–3702 | Cite as

From will to live to will to die: oncologists, nurses, and social workers identification of suicidality in cancer patients

  • Leeat GranekEmail author
  • Ora Nakash
  • Samuel Ariad
  • Wendy Chen
  • Shira Birenstock-Cohen
  • Shahar Shapira
  • Merav Ben-David
Original Article



The purpose of this research was to examine how oncologists, nurses, and social workers identify suicidality in cancer patients.


Sixty-one healthcare professionals (23 oncologists, 18 social workers, and 20 nurses) at two academic cancer centers were interviewed using an in-depth interview guide. This was a qualitative study based on grounded theory methodology. Analysis involved line-by-line coding, with categories and themes emerging from participants’ narratives.


Suicidality in cancer patients exists on a wide spectrum that ranges from an active will to live to an active will to die. Four phases were identified that included: (A) a strong will to live expressed in themes of active treatments, seeking second opinions, overtreatment, and alternative treatments; (B) a decreasing will to live indicated in themes of mental health distress and physical pain and suffering; (C) a readiness to die expressed in themes of mental health distress, previous mental health diagnoses, physical pain, avoiding more suffering, preserving quality of life in old age, nearing end of life, lack of social support, and maintaining a sense of control; and (D) a will to die indicated in themes of euthanasia and active suicidality.


Suicidality in cancer patients exists on a continuum. Cancer patients fluctuate on this spectrum depending on circumstances such as degree of suffering, their personalities and life circumstances, and whether they are nearing the end of life. Results of the study emphasize the need to collect more context specific data on suicidality among cancer patients and the importance of early integration of psychosocial and palliative care in the cancer treatment trajectory.


Assessment Suicidality Cancer Oncology 


Compliance with ethical standards

Approvals were obtained from the Research Ethics Board prior to launching the study. Informed consent was obtained from all individual participants included in the study that agreed to the interview being audio-recorded. A semi-structured interview guide was used and interviews were recorded and transcribed, with all identifiable information removed from the transcripts.

Conflict of interest

The authors declare that they have no conflict of interest.


This work was supported by the American Foundation for Suicide Prevention [Pilot Research Grant to Granek].


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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Leeat Granek
    • 1
    Email author
  • Ora Nakash
    • 2
  • Samuel Ariad
    • 3
  • Wendy Chen
    • 4
  • Shira Birenstock-Cohen
    • 5
  • Shahar Shapira
    • 6
  • Merav Ben-David
    • 7
  1. 1.Department of Public Health, Faculty of Health SciencesBen-Gurion University of the NegevBeer ShevaIsrael
  2. 2.Baruch Ivcher School of PsychologyInterdisciplinary CenterHerzilyaIsrael
  3. 3.Department of Oncology, Soroka University Medical CenterBen-Gurion University of the NegevBeer ShevaIsrael
  4. 4.Department of Social ServicesSheba Medical CenterRamat-GanIsrael
  5. 5.Department of OncologySoroka University Medical CenterBeer ShevaIsrael
  6. 6.Gender Studies ProgramBen-Gurion University of the NegevBeer ShevaIsrael
  7. 7.Radiation Oncology, Sheba Medical Center, Ramat-Gan, Israel & Sackler School of MedicineTel Aviv UniversityTel AvivIsrael

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