Approved by the Cancer.Net Editorial Board, 01/2016
Post-traumatic stress disorder (PTSD) is an anxiety disorder. A person may develop PTSD after experiencing an extremely frightening or life-threatening situation. PTSD is most often associated with traumatic events such as war, sexual and physical attacks, natural disasters, and serious accidents. But it can also affect people with a history of cancer. For example, a recent study found that nearly 1 in 4 women who were newly diagnosed with breast cancer experienced PTSD.
Some aspects of the cancer experience that might trigger PTSD include:
- Being diagnosed with the disease
- Diagnosis of an advanced cancer
- Painful tests and treatments
- Pain from the cancer itself or other physical issues
- Test results
- Long hospital stays or treatments
- A cancer recurrence or the potential for recurrence
Signs and symptoms of PTSD
It is normal for a person with cancer or a cancer survivor to have feelings of anxiety, such as worry, fear, and dread. However, if these feelings do not go away over time, continue to get worse, or affect daily life, they could be a sign of PTSD.
Other symptoms of PTSD include:
- Nightmares and flashbacks
- Avoiding places, events, people, or things that bring back bad memories
- Strong feelings of guilt, hopelessness, or shame
- Trouble sleeping or concentrating
- Continuous feelings of fear or anger
- Loss of interest in activities and relationships that used to be enjoyable
- Self-destructive behavior, such as drug or alcohol abuse
- Frightening or unwanted thoughts
- Difficulty feeling emotions
PTSD symptoms are different for each person and can come and go. The symptoms usually develop within 3 months of a traumatic even. But they can also occur several months or even years later. If you experience any of these symptoms and they last more than 1 month, talk with your doctor or a member of your health care team.
People with cancer and cancer survivors who have PTSD need have treatment because the disorder can keep them from getting needed tests, cancer treatments, or follow-up care. PTSD can also increase a person’s risk of developing other mental, physical, and social problems. These can include depression, alcohol and drug abuse, eating disorders, and loss of relationships and employment.
Risk factors for PTSD
It is not clear why some people develop PTSD while others do not. Certain factors may make a person more likely to develop the disorder, including a younger age at diagnosis. One study found that survivors of childhood cancer—especially those who had longer and more intensive treatment plans—had an increased risk of developing PTSD. Another found that nearly 20% of infants and preschoolers with cancer experience PTSD.
PTSD also seems to be more common for:
- People who have had PTSD or other mental health conditions before being diagnosed with cancer
- Women from minority groups
- People with high levels of overall stress
- People who use avoidance strategies to cope with stress, such as drugs or alcohol
- People with less formal education
- People with low or no income
- Single people
However, a person with cancer or a survivor is less likely to develop PTSD if they:
Receive strong support from family and friends
Are given correct information about the stage of the cancer
Have good relationships with members of the health care team
PTSD and caregivers
PTSD can also affect caregivers. Learning that a loved one has cancer, seeing a loved one in pain, and experiencing a medical emergency are traumatic events. And they may contribute to the development of PTSD symptoms during treatment or years after the person has survived the cancer. One study found that nearly 20% of families with teenaged survivors of childhood cancer had a parent who was experiencing PTSD. Research also shows that it is extremely common for parents of children receiving cancer treatment to develop stress-related symptoms.
Treatment of PTSD
PTSD is treatable. Which treatment works best depends on a person’s specific symptoms and situation. Common treatments are listed here and are often combined.
- Psychotherapy. This means talking with a mental health professional, like a counselor, who has experience treating PTSD. Some counselors specialize in helping people who have or have had cancer. Therapy can be done 1-on-1 or in a group setting. Some health insurance companies pay for a portion of the treatment. Read more about the benefits of counseling.
- Medications. Antidepressants and anti-anxiety drugs can help manage PTSD symptoms, such as sadness, anxiety, and anger. Medication is often used in combination with psychotherapy.
- Support groups. Support groups can help people cope with the emotional aspects of cancer. They provide a safe place to share experiences and learn from other people facing similar situations. Research shows that support groups can help people with cancer feel less depressed and anxious and become more hopeful. Learn more about support groups.
Find support for PTSD
Many PTSD resources are available. Talk with your doctor or another member of your health care team for help and recommendations. Your hospital’s social work or discharge department may also be able to connect you with counseling services and support groups in your community. Here are some other tips for finding help:
- Contact your local health department, community mental health agency, or family services agency.
- If your workplace has an employee assistance program, ask if it provides mental health counselor referrals.
- Ask your health insurance company for a list of local mental health counselors.
- Use free online referral services, such as the Anxiety and Depression Association of America’s Find a Therapist tool and the Substance Abuse and Mental Health Services Administration’s Behavioral Health Treatment Services Locator.
- Contact the American Psychosocial Oncology Society's helpline by calling 866-276-7443.
National Cancer Institute: Cancer-Related Post-Traumatic Stress
© 2018 American Society of Clinical Oncology. All rights reserved. Retrieved from https://www.cancer.net/survivorship/life-after-cancer/post-traumatic-str... 27, 2018. Reprinted with permission.