Post-traumatic stress disorder (PTSD) is a psychological condition that develops in the aftermath of a particularly distressing event. The condition can be debilitating for many; it can lead to avoidance of places and contexts reminiscent of the trauma and may result in social isolation and negative coping strategies, such as substance abuse.
It may come as no surprise, then, that many people diagnosed with cancer also develop PTSD. This is not just because the news always comes as a shock, but also because the aggressiveness of the treatment itself is often traumatic, as studies have confirmed.
New research from the National University of Malaysia in Bangi now shows that a large number of people who have experienced cancer develop PTSD and may continue to live with this condition even after successful cancer treatment. For some, the PTSD symptoms even worsen with time, explain the authors.
Lead author Caryn Mei Hsien Chan, Ph.D., and colleagues published their findings in a paper in the journal CANCER.
Cancer diagnosis often followed by PTSD
Chan and team worked with 469 adults who had been diagnosed with different types of cancer. These were all recruited within 1 month of their diagnosis, at the same oncology referral clinic.
They were evaluated for PTSD symptoms first after 6 months following their cancer diagnosis, and then again after 4 years.
The team found that nearly one fifth of the study participants were also facing PTSD within a few months of their cancer diagnosis, and many of these people continued to exhibit PTSD symptoms after 4 years.
Six months following the participants' cancer diagnoses, Chan and colleagues noted a 21.7 percent incidence of PTSD. The incidence fell to 6.1 percent at the 4-year follow-up, but approximately one third of the people earlier diagnosed with PTSD exhibited persistent or even worsening symptoms of the condition at this point.
Therefore, the researchers suggest that healthcare professionals should screen cancer patients for signs of PTSD early on and make sure they get the support and treatment that they need.
"Many cancer patients believe they need to adopt a 'warrior mentality,' and remain positive and optimistic from diagnosis through treatment to stand a better chance of beating their cancer. To these patients, seeking help for the emotional issues they face is akin to admitting weakness."
Caryn Mei Hsien Chan, Ph.D.
One reason why some may continue to live with PTSD even after successful cancer treatment is because they may fear a return of the disease, says Chan.
They may also be avoidant of hospital settings in general, and they might fail to seek treatment for unrelated diseases or conditions because this might trigger traumatic memories about cancer and cancer therapy.
They also noted that people diagnosed with breast cancer, in particular, were more exposed to PTSD. These people were 3.7 times less likely to be diagnosed with this condition within 6 months from receiving the cancer diagnosis. However, this was not the case at the 4-year follow-up.
This finding may be owed to the fact that all the participants attended the same oncology referral center, which offers a support program targeting people diagnosed with breast cancer.
The overall results of the study, the researchers emphasize, indicate the stringent need to offer psychological support from the initial cancer diagnosis through the whole process of cancer treatment.
"We need psychological evaluation and support services for patients with cancer at an initial stage and at continued follows-up because psychological well-being and mental health — and by extension, quality of life — are just as important as physical health," urges Chan.