Oncology Rounds

How to help the 20% of cancer patients experiencing PTSD symptoms

by Deirdre Saulet and Soleil Shah

Mental distress experienced before or after a cancer diagnosis can actually decrease patients' chances of survival. A new study published in Cancer looked at the prevalence of post-traumatic stress disorder (PTSD) among cancer patients. Keep reading to see what they found and how your cancer program can help.

Risk for developing PTSD remains for years after cancer diagnosis

To conduct the study, researchers followed a cohort of 469 patients after their cancer diagnoses. Patients from this cohort with significant psychological distress, or those who received a score of 16 or higher on the Hospital Anxiety and Depression Scale, underwent PTSD screenings six months and four years after their diagnosis.

The study found that more than one-fifth of cancer patients showed PTSD symptoms within six months of their diagnosis. Approximately one-third of those patients went on to develop chronic or full PTSD after four years. So, aside from the high prevalence of PTSD six months after a cancer diagnosis, PTSD may remain persistent or worsen even four years later.

Distress can lead patients to avoid necessary cancer treatments

Roughly half of the initial cohort had significant psychological distress one month after their cancer diagnosis, underscoring how traumatic a cancer diagnosis is even if patients do not meet the criteria for a PTSD diagnosis. In fact, the National Cancer Institute reports that 25% of cancer survivors experience depression, 45% of cancer survivors experience anxiety, and that cancer survivors are twice as likely to commit suicide as the general population.

Distress can also lessen the likelihood of recovering from cancer. For example, patients may skip scans or doctor appointments to avoid reminding themselves of their traumatic diagnosis or prior treatments. This, along with the physical toll of emotional distress, may explain why cancer patients with higher levels of distress have a 32% greater risk of total cancer mortality.

Short-term solutions begin in the cancer program

There are several actions that cancer programs can take to help reduce the psychological burden of cancer. First and foremost, all cancer programs should incorporate regular distress screening into their workflow. Then, it's critical for organizations to stratify patients according to symptom severity so that high-risk patients will be connected quickly and efficient to necessary services. Low-acuity patients can receive tailored educations to help them manage their distress.

In addition, the care team within the cancer program should be required to undergo training related to the psychological aspects of cancer care. This includes learning how to normalize issues surrounding mental health and combat stigma that cancer patients may face. Many programs also have an opportunity to build partnerships and collaborate with their organization's psychiatric and behavioral health experts. Finally, the cancer program should strive to provide more accessible, free counseling services for patients or provide funds for external mental health services.

 

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