Post-Traumatic Stress Disorder and Cancer

This section has been reviewed and approved by the Cancer.Net Editorial Board, 11/2013

Key Messages:

  • Some people with cancer may develop an anxiety disorder called post-traumatic stress disorder (PTSD) as a result of their experiences with the disease.  
  • Feelings of anxiety that do not go away over time, continue to get worse, or interfere with daily life could be a sign of PTSD.
  • Specific individual, social, and economic factors may put a person at greater risk of developing PTSD.
  • PTSD, which can also affect caregivers, is often treated with individual or group therapy, medication, or a combination of these and other methods; ask your doctor for PTSD resources.

PTSD is an anxiety disorder that a person may develop after experiencing an extremely frightening or life-threatening situation. Although PTSD is most often associated with traumatic events such as war, sexual and physical attacks, natural disasters, and serious accidents, the disorder can also affect people with a history of cancer. For example, a recent study found that nearly one in four women who were newly diagnosed with breast cancer experienced PTSD.

Some 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
  • Lengthy hospital stays or treatments
  • A cancer recurrence (cancer that comes back after treatment) or the potential for recurrence

Signs and symptoms

It is normal for a person with cancer or a cancer survivor to have feelings of anxiety, such as worry, fear, and dread. However, if these feelings do not go away over time, continue to get worse, or interfere with day-to-day life, they could be a sign of PTSD.

Other symptoms of PTSD include:

  • Nightmares and flashbacks (repeatedly reliving an event)
  • Avoiding places, events, people, or things that bring back memories of the cancer experience
  • Strong feelings of guilt, hopelessness, or shame
  • Trouble sleeping or concentrating
  • Continuous feelings of fear, irritability, or anger
  • Loss of interest in activities and relationships that used to be enjoyable
  • Self-destructive behavior, such as drug or alcohol abuse
  • Frightening or unwanted thoughts
  • Difficulty feeling emotions

PTSD symptoms are different for each person and can come and go. Although these symptoms usually develop within three months of a traumatic event, they can occur several months or even years later. If you experience any of these symptoms and they last more than one month, talk with your doctor or another member of your health care team.

It is important that people with cancer and cancer survivors who have PTSD are treated because the disorder can keep them from getting needed tests, treatments, or follow-up care. PTSD can also increase a person’s risk of developing other mental, physical, and social problems, including depression, alcohol and drug abuse, eating disorders, and loss of relationships and employment.

Risk factors

It is not clear why some people develop PTSD while others do not. Certain factors may make a person more likely to develop the disorder, including a younger age at diagnosis. One study found that survivors of childhood cancer, especially those who had longer and more intensive treatment plans, had an increased risk of developing PTSD. Another found that nearly 20% of infants and preschoolers with cancer experience PTSD.

PTSD also seems to be more common for:

  • People who have had PTSD or other mental health conditions before being diagnosed with cancer
  • Women from minority groups
  • People with high levels of overall stress
  • People who use avoidance strategies to cope with stress, such as using drugs or alcohol
  • People with less formal education
  • People with low or no income
  • Single people

Factors that may make a person with a history of cancer less likely to develop PTSD include:

  • Getting strong support from family and friends
  • Being given correct information about the stage of the cancer (where it is located, if or where it has spread, and if it is affecting other parts of the body)
  • Having good relationships with members of the health care team

PTSD and Caregivers

PTSD can also affect caregivers. Learning that a loved one has cancer, seeing a loved one in pain, and experiencing a medical emergency are traumatic events that may contribute to the development of PTSD symptoms during treatment or years after the person has survived the cancer. One study found that nearly 20% of families with adolescent survivors of childhood cancer had at least one parent who was experiencing PTSD. Research also shows that it is extremely common for parents of children undergoing cancer treatment to develop stress-related symptoms.

Treatment

PTSD is treatable. Which treatment works best depends on a person’s specific symptoms and situation. Common treatments are listed here and are often combined.

Psychotherapy. This means talking with a mental health professional, like a counselor, who has experience treating PTSD. Some counselors specialize in helping people who have or have had cancer. Therapy can be done one-on-one or in a group setting. Some health insurance companies pay for a portion of the cost of this treatment. Read more about the benefits of counseling.

Medications. Antidepressants and anti-anxiety drugs can help manage PTSD symptoms, such as sadness, anxiety, and anger. Medication is often used in combination with psychotherapy.

Support groups. Support groups can help people cope with the emotional aspects of cancer by providing a safe place to share experiences and learn from other people who are facing similar situations. Research shows that support groups can help people with cancer feel less depressed and anxious and become more hopeful. Learn more about support groups.

Resources

There are many PTSD resources available, so talk with your doctor or another member of your health care team for help and recommendations. Your hospital’s social work or discharge department may also be able to connect you with counseling services and support groups in your community. Here are some other tips for finding help:

More Information

Coping

Survivorship

How an Oncology Social Worker Can Help

Post-Traumatic Growth From Cancer

Support and Resource Links

Additional Resources

National Cancer Institute: Post-Traumatic Stress Disorder

National Institute of Mental Health: What is Post-Traumatic Stress Disorder (PTSD)?