When Cancer Triggers Post-Traumatic Stress

  • Symptoms of post-traumatic stress syndrome (PTSS) are usually tied to events like war, natural disaster, or sexual assault. But often, they can affect people with cancer, too.  

    PTSS are anxiety symptoms that can develop after a person has a deeply frightening or disturbing experience.

    While it can be hard, post-traumatic stress syndrome can prompt cancer patients to reprioritize their lives in meaningful ways.  “There’s an opportunity for post-traumatic growth,” Dr. Doubrava said.

     “Some patients perceive a diagnosis of cancer as being life-threatening, and that perception can trigger serious trauma, even if they have a very good prognosis,” explained Suzanne Doubrava, MD, a psychiatrist at Fox Chase Cancer Center. “They’re in a constant state of fear and terror that keeps repeating.”

    Undergoing treatment, having a long hospital stay, waiting for test results, or even being afraid of cancer coming back can also trigger symptoms.

    A recent study found that as many as 1 in 5 people with cancer had some symptoms of PTSS six months after diagnosis and that one-third of those still had PTSS four years later. The heightened anxiety, worry, or fear can make it impossible to feel calm or relaxed, and can interfere with a patient’s daily life, according to Paula H. Finestone, PhD, a psychologist at Fox Chase.

    Having PTSS may even affect a cancer patient’s health—if, for instance, being in their doctor’s waiting room or smelling alcohol swabs triggers anxiety symptoms, that patient might be more likely to skip appointments or avoid treatment.

    Recognizing PTSS symptoms in cancer patients

    People with cancer can develop symptoms of PTSS shortly after their diagnosis, but their problems can occur anytime during or after treatment. If they are experiencing PTSS, they might:

    • Constantly feel anxious, worried, scared, or angry
    • Have nightmares and flashbacks to cancer-related events
    • Avoid places, events, or people that trigger bad memories
    • Have intense feelings of guilt, shame, or hopelessness
    • Have trouble sleeping or concentrating
    • Lose interest in activities or relationships that used to be enjoyable
    • Have scary or unwanted thoughts
    • Partake in self-destructive activities, such as abuse drugs or alcohol
    • Feel numb

    Although PTSS can affect anyone with cancer, patients who’ve experienced a previous trauma or PTSS unrelated to cancer are at higher risk.

    “Worry is trying to predict a future that no one knows," said Dr. Finestone. "The way you let go of worry is to coach yourself: deliberately let that worry go and do something else that calms you.”

    Get the help you need

    PTSS can feel overwhelming, but they are treatable. Talk with your oncology team if you think you may have PTSS. They may recommend options like:

    Cognitive behavioral therapy. This type of therapy can help you become less sensitive to triggers by teaching you how to understand your symptoms and how to change your anxiety-causing thinking patterns.

    Relaxation techniques. “When faced with a trigger, taking deep breaths or imagining a peaceful place can slow your stress reaction and help you feel calmer,” Finestone said. 

    Connecting with others. Going to a cancer support group and talking with people who are going through the same thing can give you new ideas for coping with your feelings. “Some people benefit from the buddy system, having a peer that’s gone through the same experiences,” Finestone said.

    Medications. Antidepressants, selective serotonin reuptake inhibitors (SSRIs), antianxiety drugs, and antipsychotic drugs can be useful for managing severe symptoms of PTSS.  

    And while it can be hard, PTSS can prompt cancer patients to reprioritize their lives in meaningful ways.

    “There’s an opportunity for post-traumatic growth,” Doubrava said. “PTSS becomes a powerful motivator for people to make positive changes that improve their lives.”