Assessment
It is important that cancer patients undergo a careful assessment for post-traumatic stress disorder (PTSD) so that early symptoms may be identified and treated. The timing of this assessment will vary with the individual patient. Cancer is an experience of repeated traumas and
undetermined length. The patient may experience stress symptoms anytime from diagnosis through completion of treatment and cancer recurrence. In patients
who have a history of victimization (such as Holocaust survivors) and who have
PTSD or its symptoms from these experiences, symptoms can be started again by
certain triggers experienced during their cancer treatment (for example, clinical procedures such as being inside MRI or CT scanners). While these
patients may have problems adjusting to cancer and cancer treatment, their PTSD
symptoms may vary, depending on other factors. The symptoms may become more or
less prevalent during and after the cancer treatment.
Symptoms of PTSD usually begin within the first 3 months after the trauma, but
sometimes they do not appear for months or even years afterwards. Therefore,
cancer survivors and their families should be involved in long-term monitoring.
Some people who have experienced an upsetting event may show early symptoms
without meeting the full diagnosis of PTSD. However, these early symptoms
predict that PTSD may develop later. Early symptoms also indicate the need for
repeated and long-term follow-up of cancer survivors and their families.
Diagnosing PTSD can be difficult since many of the symptoms are similar to
other psychiatric problems. For example, irritability, poor concentration,
increased defensiveness, excessive fear, and disturbed sleep are symptoms of
both PTSD and anxiety disorder. Other symptoms are common to PTSD, phobias,
and panic disorder. Some symptoms, such as loss of interest, a sense of having
no future, avoidance of other people, and sleep problems may indicate the
patient has PTSD or depression. Even without PTSD or other problems, normal
reactions to the cancer diagnosis and treatment of a life-threatening disease
can include interfering thoughts, separating from people and the world, sleep
problems, and over-excitability.
Questionnaires and interviews are used by health care providers to assess if
the patient has symptoms of stress and to determine the diagnosis.
Other problems may also exist in addition to PTSD. These problems can include substance abuse, emotional problems, and other anxiety disorders, including
major depression, alcohol dependence, drug dependence, social fears, and/or obsessive-compulsive disorder.
Back to Top
< Previous Section | Next Section > |