1 in 2 Australians will be diagnosed with cancer by the age of 85, with more than 60% of cancer patients surviving more than five years after diagnosis. This makes Australia one of the best places in the world to be diagnosed with cancer; follow up support however may not be being optimally received. According to a recent US study the hidden psychological scars caused by the diagnosis of cancer can leave scaring akin to that inflicted by war, with the impact in some cases lasting for years. Given these facts it is vital that medical practitioners and networks of support are put in place to ensure survivors continue to obtain adequate medical care.
Cancer care must include the psychological as well as the biological. According to Sophia Smith, lead researcher of the Duke Cancer Institute, one in ten cancer survivors stated that they were still plagued by symptoms of post-traumatic stress disorder, more than a decade after being diagnosed with the disease. Symptoms include avoiding situations related to the trauma, being continuously plagued by thoughts about cancer and its treatment and feeling emotionally numb towards friends and relatives. The psychological and mental shock of having a life-threatening disease, of receiving treatment and living with the repeated threats to one’s body and life are traumatic. Because the cancer experience involves so many traumatic events, it is much more difficult to single out one event as a trigger of stress than it is for other traumas such as war or rape.
PTSD in cancer survivors may be expressed in the following specific behaviours:
- Reliving the cancer experience in nightmares or flashbacks and by continuously thinking about it.
- Avoiding places, events and people connected to the cancer experience.
- Being continuously overexcited, fearful, irritable and unable to sleep.
Given these symptoms it is not surprising that one in ten patients also said they avoided thinking about their cancer and one in twenty said they steered clear of situations or activities that reminded them of the disease, highlighting an obvious issue with the potential for avoidance of vital medical care and follow up care. It is important that cancer survivors receive information about the possible psychological effects of their cancer experience and early treatment of symptoms of PTSD.
The study, published in the Journal of Clinical Oncology, surveyed 566 patients with non-Hodgkin’s lymphoma for PTSD symptoms and found that an estimated one in twelve had full-blown PTSD with many more presenting with one or more symptoms. Over half of the patients had no PTSD symptoms 13 years after their diagnosis however in 37% symptoms had remained or worsened.
Although PTSD does not affect the majority of cancer survivors, it is vital that medical practicioners, support networks and survivors themselves, are aware of the signs symptoms and the impact that this disease may continue to hold. Routine check-ups should include discussions on both biological and psychological health. Cancer survivors and there families should be involved in long-term monitoring.
Post Traumatic Stress Disorder