Publisher’s NOTE: Once again, we post the following for General consideration as it was originally published in February of 2012 – which does not demean nor oblityerate the general direction of the recommendations, however there are several medicinal recommendations made herein, the should require further investigation before committing to them. ~ J.B.
Coping with cancer could put you at risk for post-traumatic stress disorder. Here’s how to recognize the symptoms and know when to seek help.
Post-traumatic stress disorder (PTSD) is frequently linked to life-threatening disasters, accidents, personal assault, or chronic exposure to violence, but this type of anxiety disorder can also affect individuals who recover from serious illness, especially cancer. However, doctors often fail to recognize that their patients are at high risk for developing the condition.
“PTSD is not a diagnosis that is on a lot of oncologists’ radar screens,” says Dale Shepard, MD, PhD, an oncologist at the Cleveland Clinic. “That’s probably because we already assume that most patients with life-threatening cancer are going to have PTSD symptoms. Who wouldn’t have flashbacks and be fearful?”
Symptoms of PTSD can include avoidance of things that bring back disturbing memories and feelings of fear and anxiety, says Simon A. Rego, Psy.D, an assistant professor of psychiatry at Albert Einstein College of Medicine and director of psychology training at Montefiore Medical Center in the Bronx, N.Y. “The person responds with intense fear, helplessness, or horror. It would make sense that many cancer survivors would suffer symptoms of PTSD in the months after finishing cancer treatment, even if told that their cancer is in remission.”
Life After Cancer: Diagnosing PTSD
When Judy Milinowski was diagnosed with breast cancer in 1998 at age 50, she says none of her doctors warned her about psychological affects that would linger long after the disease. Milinowski, who lives in Boothbay Harbor, Maine, is a holistic medical practitioner and corporate stress management specialist. Milinowski says because of professional training she was able to recognize symptoms that may have developed into PTSD after she recovered from cancer surgery and chemotherapy. “I felt hyperactive, and it was hard to think straight,” she says. “I also sensed a strong fear that I needed to confront. I felt that the fear would somehow attract my cancer back to me if I ignored it.”
These symptoms can stay with a person long after cancer treatment ends. A survey of 566 people with non-Hodgkin’s lymphoma, published in the Journal of Clinical Oncology, found that more than a third of the participants still had symptoms of PTSD several years after their cancer diagnosis.
Children also can get PTSD after cancer. A study published in the journal Psycho-Oncology found that one in five children treated for cancer develops PTSD. Children older than 18 months were at higher risk than younger children. Rego notes that PTSD symptoms can be somewhat different in children. “In children, PTSD may be expressed as disorganized or agitated behavior,” he says.
“To be diagnosed with PTSD, several symptoms must occur and last for at least a month after cancer treatment. The symptoms must also cause significant distress or problems in the person’s social life, work life, or other important areas of functioning,” says Rego.
Coping With Cancer and PTSD
“Providing social and psychological support during and after cancer treatment is standard care for cancer,” says Dr. Shepard. “You also need to provide support for family members. Parents of a child with cancer are under tremendous stress. Some warning signs I look for are withdrawal, avoidance of care, irritability, and anger.”
Milinowski used complementary treatments to alleviate her PTSD symptoms. including meditation and visualization techniques that helped minimize stress. “I did so well after my cancer that my doctor, who had no experience with holistic medicine, asked me to work with other cancer patients. I have continued to work with cancer patients in my practice, and I have seen the effects of PTSD. I try to help them find a balance between holding on and letting go. Once you get to that place, you can surrender. The technique I use is called deep emotional release.”
Rego notes that for many people, symptoms of PTSD associated with cancer treatment tend to dissipate over time. “If this is not the case and the symptoms are persisting, then there are excellent, evidence-based treatments available.” Treatment options to consider include:
* Talk therapy: Also called cognitive behavioral therapy (CBT), this is usually the first treatment. “Research shows this is a highly effective and long-lasting treatment that can work in as little as 10 sessions,” says Rego.
* Medication: There are two FDA-approved drugs to treat PTSD: sertraline (Zoloft) and paroxetine (Paxil). Rego says that “both of these have been shown to be effective in treating PTSD.”
* Relaxation training and support groups.
“Educating patients about what to expect after cancer and making sure they have a good support system is the best way to avoid PTSD,” says Shepard. If you or a loved one is coping with life after cancer and you are having symptoms of PTSD, ask for help.
Written by Chris Iliades, MD and published by Everyday Health ~ February 14, 2012. Medically Reviewed by Pat F. Bass, III, MD, MPH
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