From the Guidelines
PTSD can significantly complicate cancer care and should be addressed alongside cancer treatment, with a focus on reducing distress, improving treatment adherence, and enhancing overall quality of life. Patients with PTSD may experience heightened anxiety, avoidance behaviors, and difficulty adhering to treatment plans, potentially impacting their cancer outcomes. To manage PTSD in cancer patients:
- Screen all cancer patients for PTSD symptoms using tools like the PCL-5 questionnaire, as recommended by recent guidelines 1.
- Refer patients with significant PTSD symptoms to mental health professionals for concurrent treatment, considering trauma-focused cognitive behavioral therapy (TF-CBT) or eye movement desensitization and reprocessing (EMDR) as first-line psychotherapy treatments 1.
- If medication is needed, selective serotonin reuptake inhibitors (SSRIs) like sertraline (50-200 mg daily) or paroxetine (20-50 mg daily) are typically recommended, although the evidence for pharmacotherapies in cancer patients is limited 1.
- Implement trauma-informed care practices in oncology settings, including clear communication, patient empowerment, and minimizing potentially triggering procedures when possible, to improve patient outcomes and reduce distress 1.
- Encourage patients to join cancer support groups that address both physical and psychological aspects of treatment, and educate oncology staff about PTSD to improve recognition and sensitivity to patients' needs 1.
- Consider integrative therapies, such as mindfulness-based interventions, music therapy, yoga, relaxation, hypnosis, tai chi, and qigong, which may be used in conjunction with conventional care to improve symptoms of anxiety and depression in people with cancer 1. By addressing PTSD symptoms, patients may experience reduced distress, improved treatment adherence, and better overall quality of life during cancer care, ultimately leading to improved morbidity, mortality, and quality of life outcomes.
From the Research
Effect of PTSD on Cancer Care
- The presence of Post-Traumatic Stress Disorder (PTSD) in cancer patients can have a significant impact on their care and quality of life 2, 3, 4.
- Studies have shown that cancer-related PTSD can lead to increased distress, reduced quality of life, and poorer treatment outcomes 4, 5.
- The prevalence of PTSD in cancer patients varies, but it is estimated to be around 2-4% in some studies 5, 6.
Diagnosis and Treatment of PTSD in Cancer Patients
- The diagnosis of PTSD in cancer patients can be complex, and careful evaluation of pre-cancer diagnosis trauma and psychiatric history is necessary 3, 4.
- Treatment of cancer-related PTSD should be approached with caution and informed by existing evidence-based approaches for traumatic stress 4, 6.
- Psychological interventions such as cognitive-behavioral therapy and eye movement desensitization and reprocessing have shown promise in reducing symptoms of cancer-related PTSD 2, 6.
Implications for Cancer Care
- The presence of PTSD in cancer patients highlights the need for comprehensive psychosocial assessment and support throughout the cancer care trajectory 3, 4.
- Healthcare providers should be aware of the potential for PTSD in cancer patients and provide appropriate referrals to mental health services 5, 6.
- Further research is needed to develop effective interventions and treatment guidelines for cancer-related PTSD 2, 3, 6.