Post-Traumatic Stress Disorder and Cancer

Approved by the Cancer.Net Editorial Board, 03/2019

Post-traumatic stress disorder (PTSD) is an anxiety disorder. A person may develop PTSD after experiencing a frightening or life-threatening situation.

PTSD is most often associated with these traumatic events:

War
Sexual and physical attacks
Natural disasters
Serious accidents

But people with cancer may experience it too. For example, one study shows that nearly 1 in 4 women newly diagnosed with breast cancer experienced PTSD.

Aspects of the cancer experience that might trigger PTSD include:

The diagnosis
Pain from the cancer or other physical issues
Tests and treatments
Test results
Long hospital stays or treatments
The cancer's return or fear of its return

Signs and symptoms of PTSD

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

Other symptoms of PTSD include:

Nightmares and flashbacks
Avoiding places, events, people, or things that bring back bad memories
Strong feelings of guilt, hopelessness, or shame
Trouble sleeping or concentrating
Continuous feelings of fear 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. The symptoms usually develop within 3 months of a traumatic event. But they can also occur several months or even years later. If you have any of these symptoms and they last more than a month, talk with your health care team.

People with cancer and cancer survivors who have PTSD need treatment because the disorder can keep them from getting needed tests, cancer treatments, or follow-up care. PTSD can also increase a person’s risk of developing other mental, physical, and social problems. These can include depression, alcohol and drug abuse, eating disorders, and loss of relationships and employment.

Risk factors for PTSD

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 being diagnosed with cancer at a young age. One study found that survivors of childhood cancer—especially those who had longer and more intensive treatment—had an increased risk of developing PTSD. Another study found that nearly 20% of infants and preschoolers with cancer have 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 drugs or alcohol
People with less formal education
People with low or no income
Single people

People with cancer and survivors are less likely to have PTSD if they:

Receive strong support from family and friends
Are given correct information about the stage of the cancer
Have good relationships with their 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 having a medical emergency are traumatic events. A caregiver may develop PTSD during treatment or years after the person they are caring for has survived the cancer.

One study found that nearly 20% of families with teenage survivors of childhood cancer had a parent who was experiencing PTSD. Research also shows that it is common for parents of children receiving cancer treatment to develop stress-related symptoms.

Treatment of PTSD

PTSD is treatable. Treatments depend 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 1-on-1 or in a group setting. Some health insurance companies pay for a portion of the treatment. Read more about the benefits of counseling.

Medication. 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. They provide a safe place to share experiences and learn from other people 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.

Find support for PTSD

Talk with your health care team for help in finding resources for PTSD. 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:

Contact your local health department, community mental health agency, or family services agency.
If your workplace has an employee assistance program, ask if it provides mental health counselor referrals.
Ask your health insurance company for a list of local mental health counselors.
Use free online referral services, such as the Anxiety and Depression Association of America’s Find a Therapist tool and the Substance Abuse and Mental Health Services Administration’s Behavioral Health Treatment Services Locator.