Acknowledging Cancer’s PTSD-Causing Trauma

Polls in the United States and Europe revealed that half the population are more afraid of cancer than any other disease. Cancer is, after all, a life-altering event that can trigger a rollercoaster of emotional and psychological responses. For many who experience this fear, they may continue to grapple with lingering trauma long after treatment. This trauma can manifest as cancer-related post-traumatic stress disorder (PTSD), a condition that mirrors the symptoms of traditional PTSD.

What is the difference between PTS and PTSD?

About one in five people diagnosed with cancer exhibit signs of either:

• Post-traumatic stress (PTS) is considered a normal response to a traumatic life event. A patient or survivor with this condition may feel anxious or nervous during an examination or doctor’s appointment.
• Post-traumatic stress disorder (PTSD) is more severe and can last longer than PTS. A patient might be struggling with PTSD if their PTS symptoms persist beyond one to three months; if they are too anxious or afraid to go to appointments; or if they feel paralyzed and unable to live life.

What are the causes and triggers?

Cancer-related PTS and PTSD may result from one, or sometimes all, of the following moments during cancer or its treatment:

• Initial diagnosis or hearing “you have cancer” for the first time
• During blood tests, screenings, or other procedures
• Getting very sick or staying in the hospital, especially the intensive care unit (ICU)
• Experiencing physical changes or side effects related to cancer or its treatment
• Before attending follow-up appointments or tests (sometimes referred to as “scanxiety”)

What are the signs of cancer-related PTSD?

Healthcare providers, loved ones, and patients themselves may overlook or misunderstand cancer-related PTS and PTSD, as the symptoms can overlap with other emotional responses to cancer. Recognizing the signs is a step toward seeking appropriate help and support.

Cancer-related post-traumatic stress has symptoms similar to those of traditional PTSD, which can include:

• Flashbacks and intrusive thoughts: Patients may relive their cancer diagnosis, treatment sessions, or other traumatic moments. These flashbacks, which certain sounds, smells, or situations can easily trigger, can be vivid and distressing.
• Severe anxiety and panic attacks: Constant worry about cancer recurrence can lead to heightened anxiety. Panic attacks, sweating, and a feeling of impending doom, may occur frequently.
• Avoidance behavior: Patients and survivors might avoid places, people, or activities that remind them of their cancer. They might skip medical appointments, avoid hospitals, or distance themselves from support groups.
• Emotional numbness: Emotionally numb patients feel detached from life and relationships. They might struggle to feel happy or participate in activities they once enjoyed.
• Hypervigilance: Being on edge or overly alert can make it difficult for survivors to relax. This heightened state of arousal can interfere with sleep and concentration.

Emotionally, individuals may experience:

• Depression: Persistent sadness, hopelessness, and a lack of interest in almost anything are common in cancer patients.
• Irritability and anger: Feelings of frustration and anger can surface, which they might direct toward themselves or others.
• Guilt and shame: They might feel guilty about their illness or ashamed of the changes in their physical appearance.

Physically, PTSD can manifest through:

• Chronic pain: Stress can cause muscles to tense up, which, over time, can lead to pain and soreness.
• Sleep disturbances: Difficulty falling asleep, staying asleep, or experiencing nightmares is common in people with PTS or PTSD.
• Fatigue: An overload of stress hormones can cause anyone to experience fatigue and exhaustion, even with enough sleep.

Learning how to cope with cancer-related PTSD triggers can help patients and survivors lead the fulfilling lives they deserve.

What are the treatments for PTS and PTSD?

Trauma affects each person differently. Patients must collaborate with their healthcare team to develop a personalized plan that suits them best. The goal of treatment is to assist them in acquiring effective, healthy coping mechanisms.

Treatment for cancer-related PTS or PTSD works best in combination with various approaches, including:

• • Medication: Prescription meds for anxiety or depression can help with negative, intrusive thoughts or feelings. Sertraline (Zoloft) and paroxetine (Paxil) are examples of FDA-approved selective serotonin reuptake inhibitor (SSRI) medications for PTSD treatment.
  • Cognitive behavioral therapy (CBT): This psycho-social intervention for PTSD can help reduce avoidance behaviors and improve how patients process their feelings.
  • Eye movement desensitization and reprocessing (EMDR): This form of psychotherapy uses talk therapy and directed eye movements to help the brain heal from cancer-related trauma and other past life experiences.
  • Exposure therapy: Exposure therapy can help survivors face their triggers and discover ways to cope with them. However, it can backfire if the patient exposes themselves to their triggers too soon or too much.

• Lifestyle habits: Meditation, exercise, good sleep, and journaling are some examples of habits that can help manage post-traumatic stress and bring other health advantages.

• Support groups: Support groups allow cancer patients and survivors to talk with others who have had similar experiences. Even with amazing friends and family, support groups can help patients heal by seeing, feeling, and acknowledging that they are not alone.

Can loved ones and caregivers develop PTSD?

The people around cancer patients can and often experience PTS and PTSD, too.

Finding out someone they love has cancer, witnessing their pain, and supporting them through their healing journey can be very traumatic. In fact, a study revealed that one in five families with teenage cancer survivors had a parent who developed PTSD. Furthermore, research indicates that parents of children undergoing cancer treatment frequently experience symptoms related to stress. Of course, it’s not only parents who can experience PTSD; spouses, children, and other caregivers are also at risk.

Leaving PTSD unaddressed can increase the risk of alcohol or drug misuse, eating disorders, or even suicide-provoking depression. Patients and the people around them must vigilantly monitor for signs of PTS or PTSD to overcome any emotional and mental health challenges.

If you’re experiencing symptoms of PTSD, reach out to your cancer care team and ask them to connect you with a psychiatrist, psychologist, or counselor. These mental health professionals can equip you with strategies to manage your emotions, cope with stressful situations, and ultimately alleviate the symptoms of post-traumatic stress disorder.