Post-traumatic Stress Disorder (PTSD) After Cancer

Anyone can feel stress after going through a scary or traumatic event. For people with cancer, these feelings can happen at any point – from the time of their diagnosis, through treatment, and even after treatment ends.

Sometimes, these feelings can become more severe and lead to other conditions such as post-traumatic stress disorder (PTSD) and acute stress disorder. PTSD is more serious, often harder to treat, and can last for years. Learn more about PTSD and other post-traumatic stress reactions, how they affect people with cancer, and where to find help and support.

What is PTSD?

PTSD is a mental health condition that can develop after a scary or life-threatening event. It most often follows events such as living through war, physical or sexual assault, abuse, or serious accidents.

Cancer can lead to PTSD in some people if they experience a traumatic event during diagnosis or treatment.

How is PTSD different than other types of traumatic stress?

There are several types of stress reactions:

• Post-traumatic stress (PTS)
• Acute stress disorder (ASD)
• Post-traumatic stress disorder

PTS is a common and normal response that often gets better with time and support. People with PTS may have 1 or more symptoms that last for days to weeks, but they can still manage daily activities. People who have or had cancer may experience some level of PTS. This is sometimes called cancer-related PTS or CR-PTS. You might be experiencing PTS or CR-PTS if you feel anxious or nervous before a scan, test, or doctor’s visit.

ASD causes several physical and emotional symptoms that start within 3 to 30 days after the traumatic event and last up to 1 month. These symptoms can make daily life or relationships harder.

PTSD is more serious. It involves stronger, longer-lasting symptoms that can greatly affect your life. You might have PTSD if your symptoms start within 1 to 3 months of the traumatic event, last longer than 1 month, keep you from going to appointments or tests, and keep you from living your life.

PTSD can also increase your risk of other problems such as depression, alcohol or drug misuse, and eating disorders. It can also affect your relationships and work.

What are the symptoms of PTS, ASD, and PTSD?

Symptoms of PTS, ASD, and PTSD include:

• Disturbing memories, nightmares, or flashbacks
• Avoiding people, places, or activities that remind you of the trauma
• Feeling constantly on edge, anxious, or unable to focus
• Low mood, numbness, or difficulty connecting with others
• Sleep problems
• Emotional outbursts or self-harming behaviors
• Guilt, shame, or blaming yourself for what happened

Having these symptoms doesn’t mean you have PTS, ASD, or PTSD. But if these symptoms happen every day for more than a few days, you should talk to your cancer care team or primary care provider (PCP). Ask them for a referral or if there are other resources that can help.

Who is at risk for cancer-related PTS, ASD, and PTSD?

Not all people with cancer are at risk for PTS, ASD, and PTSD. And not all people with PTS or ASD go on to develop PTSD. There are different factors that can play a role.

Causes and triggering events

Like other types of mental distress, there is usually not one single cause of PTS, ASD, or PTSD. But there are certain times or events during cancer or cancer treatment that might be more traumatizing or triggering for you, like:

• When you are first diagnosed or told that you have cancer
• When you get tests, labs, or other procedures
• When you experience physical changes or side effects related to cancer treatment
• If you get very sick or stay in the hospital, especially the intensive care unit (ICU)
• Before you attend follow-up appointments, tests, or scans (sometimes called “scanxiety”)

Managing your risk

You might be at greater risk of developing PTS, ASD, or PTSD if you:

• Have a history of anxiety or depression
• Have a history of trauma, PTS, ASD, or PTSD before cancer
• Are diagnosed at a younger age, especially in childhood
• Have advanced cancer at the time of your diagnosis
• Don’t have a good support system

You can lower your risk by:

• Having a good understanding of your cancer diagnosis
• Talking honestly and openly with your doctor or cancer care team
• Having a strong support system

Studies show that people who use avoidance to cope with their thoughts, feelings, and emotions are at greater risk. It’s important to build your support system and to ask for help, if needed.