Cancer-related Post-traumatic Stress and PTSD

Anyone can develop post-traumatic stress (PTS) or post-traumatic stress disorder (PTSD) after a shocking, terrifying, or serious event.

People who have, or had, cancer may experience some level of post-traumatic stress. This is sometimes called cancer-related PTS or CR-PTS.

If it isn’t managed, CR-PTS can become post-traumatic stress disorder (PTSD), which is often harder to treat and can last for years.

What are traumatic stress and post-traumatic stress?

There are different types of traumatic stress. These have similar signs and symptoms, but they differ in when they occur, how long they continue, and how severe the impact is on a person’s life.

Acute stress disorder (ASD)

Acute stress disorder can develop within the first month after a traumatic event (such as being diagnosed with cancer, a specific procedure or event, or getting important updates on your cancer).

It’s common for people with acute stress disorder to have more symptoms of dissociation (losing awareness of yourself or what’s around you).

PTS and PTSD

Post-traumatic stress (PTS) is a normal response to a traumatic event. You might be experiencing PTS if you feel anxious or nervous when you have a scan, test, or doctor’s appointment.

Post-traumatic stress disorder (PTSD) is often more severe and can last longer than PTS. You might be experiencing PTSD if: your PTS symptoms last longer than 1 to 3 months; they are so severe that you aren’t going to appointments or tests; or they keep you from living your life.

Who is at risk for cancer-related PTS and PTSD?

Many people associate PTS and PTSD with specific traumatic events such as: combat; abuse, assault, or other violence (physical or mental); disasters (such as natural/weather events, accidents, terrorism, and pandemics); and severe injury or illness.

Studies show that more than 1 in 3 people who have, or had, cancer display signs of PTS or PTSD.

Causes and triggering events

Similar to other types of mental distress, there is usually not one single cause of cancer-related PTS and PTSD. But there are certain times or events during cancer or cancer treatment that might be more traumatizing or triggering for you:

• When you are first diagnosed or told that you have cancer.
• When you get tests, labs, or other procedures.
• When you experience physical changes or side effects related to cancer treatment.
• If you get very sick or stay in the hospital, especially the intensive care unit (or ICU).
• Before you attend follow-up appointments, tests, or scans (sometimes called “scanxiety”).

Managing your risk

Not all people who have, or had, cancer develop PTS or PTSD. But certain things have been shown to increase or lower a person’s risk.

You might be at greater risk of developing cancer-related PTS or PTSD if you:

• Have a history of anxiety or depression.
• Have a history of trauma, PTS, or PTSD before cancer.
• Were diagnosed at a younger age, especially in childhood.
• Have advanced cancer at the time of your diagnosis.
• Don’t have a good support system.

You can lower your risk by:

• Having a good understanding of your cancer diagnosis.
• Being able to talk honestly and openly with your doctor or cancer care team.
• Having a strong support system.

Studies show that people who use avoidance as a way to cope with their thoughts, feelings, and emotions are at greater risk of developing PTS and PTSD. It’s important to build your support system and, if you need, ask for resources to help you manage.

What are the symptoms of PTS and PTSD?

PTS and PTSD have similar signs and symptoms. If you have these symptoms, you might assume this is a normal response to cancer that can’t be helped. But, if these feelings never go away, get worse, or get in the way of your daily life, you might be experiencing PTS or PTSD.

Common signs and symptoms of PTS and PTSD:

• Nightmares, flashbacks, or intrusive thoughts
• Avoiding certain people, places, or things
• Hypervigilance (extreme caution, attention, or sensitivity to something)
• Feeling depressed or as though you can’t connect with anyone
• Not feeling interested in doing things or seeing people (or self-isolating)
• Guilt, shame, or blame about your trauma
• Trouble sleeping or sleeping too much

Having these symptoms doesn’t mean you have PTS or PTSD. But if these symptoms happen every day for more than a month, you should talk to your doctor or cancer care team. Ask them if there are resources or a referral for help.