Post-Traumatic Stress Disorder (PTSD) and Cancer
Post-traumatic stress disorder (PTSD) and cancer are often linked. In fact, as many as one-third of people who experience an extremely upsetting event, including cancer, develop it. Cancer patients generally undergo a careful assessment for PTSD so that early symptoms may be identified and treated. If present, prompt treatment for both post-traumatic stress disorder (PTSD) and cancer helps ensure that the patient has as normal a lifestyle as possible.
Some survivors of cancer experience trauma-related symptoms similar to those experienced by people who have survived highly stressful situations, such as:
- Military combat
- Natural disasters
- Violent personal attack (such as rape)
- Other life-threatening events.
This group of symptoms is called post-traumatic stress disorder (PTSD) and includes avoiding situations related to the trauma, continuously thinking of the trauma, and being overexcited.
People with histories of cancer are considered to be at risk for PTSD. The physical and mental shock of having a life-threatening disease, of receiving treatment for cancer, and living with repeated threats to one's body and life are traumatic experiences for many cancer patients.
Post-traumatic stress disorder (PTSD) is defined as the development of certain symptoms following a mentally stressful event that involved any of the following:
- Actual death or the threat of death
- Serious injury
- A threat to oneself or others.
For the person who has experienced a diagnosis of cancer, the specific trauma that triggers PTSD is unclear. It may be:
- The actual diagnosis of a life-threatening illness
- Aspects of the treatment process
- Test results
- Information given about a recurrence of the disease
- Some other aspect of the cancer experience.
Also, learning that one's child has cancer is traumatic for many parents.
Because the cancer experience involves so many upsetting events, it is much more difficult to single out one event as a cause of stress than it is for other traumas, such as natural disasters or rape. The traumatic event may cause responses of extreme fear, helplessness, or horror, and may trigger PTSD symptoms.
PTSD in cancer survivors may be expressed in these specific behaviors:
- Reliving the cancer experience in nightmares or flashbacks or by continuously thinking about it
- Avoiding places, events, and people connected to the cancer experience
- Being continuously overexcited, fearful, irritable, and unable to sleep.
To be diagnosed as PTSD, these symptoms must last for at least one month and cause significant problems in the patient's personal relationships, employment, or other important areas of daily life. Patients who have these symptoms for less than one month often develop PTSD later.
PTSD symptoms develop by both conditioning and learning. Conditioning explains the fear responses caused by certain triggers that were first associated with the upsetting event. Neutral triggers (such as smells, sounds, and sights) that occurred at the same time as upsetting triggers (such as chemotherapy or painful treatments) later cause anxiety, stress, and fear, even when they occur alone, after the trauma has ended. Once established, the symptoms of post-traumatic stress disorder are continued through learning. The patient learns that avoiding the triggers prevents unpleasant feelings and thoughts, so coping by avoidance continues.
Although conditioning and learning are part of the process, many factors may explain why one person develops PTSD and another does not.