All types of battles can cause posttraumatic stress disorder (PTSD). Fighting cancer is one of them. A multidisciplinary team of oncology nurses and other practitioners recently reported on cancer-related PTSD and how oncology nurses can help their patients with this newly defined disorder.1,2

PTSD is the result of a person’s inability to recover from a traumatic event. A constant fear of re-experiencing the event persists through nightmares or flashbacks of the trauma. Its symptoms become pathological if accompanied by associated distress and difficulty functioning for more than a month after the traumatic event. The Diagnostic and Statistical Manual of Mental Disorders Fourth Edition-Text Revision (DSM-IV-TR) expanded the definition of a traumatic event to include receiving a diagnosis of a life-threatening illness.3 These definitions were adjusted again in the latest edition, the DSM-5, to specify that a diagnosis of cancer-related PTSD requires patients to have experienced a traumatic, catastrophic event during their cancer diagnosis or treatment.4

A Traumatic Stressor

Memories related to trauma and those stemming from nontraumatic events are different. The latter are voluntary and are usually not associated with whole body experiences. Not surprisingly, the American Psychiatric Association recognizes cancer as a traumatic stressor that can result in PTSD. Approximately one-third of patients with cancer suffer from emotional distress severe enough to require a psychosocial intervention during their oncology treatment.1,2 This does not mean that all patients who require psychiatric help actually get it when they need it. Clinicians may not recognize that a patient should be referred, or the patient and/or loved ones may consider theirs a normal reaction. Some patients may try to hide what they are feeling, believing that a negative reaction to their illness or treatment will also have a negative effect on their immune system so they try to suppress their reactions. However, researchers have found that suppressing these normal responses is more damaging than processing them.

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Suppression can result in depression, difficulty sleeping, and difficulty communicating, which in turn affect treatment compliance and participation in a healing and healthful lifestyle. Studies have shown that when patients with cancer are able to process their normal negative reactions using psychological interventions, their quality of life improves. Those whose distress is not treated are less adherent to their treatment and surveillance, which results in worse disease outcomes.1,2