Even when you get rid of cancer the mental effects can still linger for a long time. A new study found that one-fifth of all patients with cancer experience post-traumatic stress disorder (PTSD) several months after diagnosis. Many patients continue to suffer from PTSD for years and years.

Image credits: Lily Lvnatikk.

Although PTSD is a condition typically thought of as emerging as a result of an accident, war, or natural disaster, it can also be triggered by a different type of event: disease. Due to its grieving nature, cancer, in particular, seems capable of triggering PTSD. Because this aspect is understudied, Caryn Mei Hsien Chan, PhD, of the National University of Malaysia, and her colleagues inspected 469 adults with various cancer types. They surveyed the patients within one month after diagnosis, six months later, and again after four years.

They found a PTSD incidence of 21.7% at 6-months follow-up, with rates dropping to 6.1% at 4-years follow-up. While the rates did go down significantly, they were still significant even after four years, comparable to war-induced PTSD, though arguably not as intense; for comparison, as many as 10% of Gulf War (Desert Storm) veterans and 11% of veterans of the war in Afghanistan suffer from PTSD.

“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,” said Dr. Chan. “There needs to be greater awareness that there is nothing wrong with getting help to manage the emotional upheaval-particularly depression, anxiety, and PTSD-post-cancer.”

The main concern for cancer survivors is that the diseases will return, but other factors are also at play. Other 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.

In addition to reducing the quality of life of patients, there are also concerns that the stress can lead to delays in seeking help for new symptoms or even refusal of treatment for unrelated conditions.

Researchers also say that their work can help better design counseling strategies for patients. For instance, patients with breast cancer were 3.7 times less likely to develop PTSD at six months than patients with other cancers, but not at four years. This likely happened because patients had access to a dedicated support program focusing on breast cancer. Focusing resources for such programs on patients more likely to suffer from PTSD and depression

“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,” said Dr. Chan.

The study has been published in the journal Cancer.