Post-traumatic stress disorder (PTSD) is an anxiety disorder that can be brought on by a traumatic event. PTSD can happen after a life-threatening situation, such as a breast cancer diagnosis or cancer recurrence. PTSD can affect your ability to cope with life’s daily chores and inconveniences and make it difficult to function.
Symptoms of PTSD include flashbacks, feelings of detachment, feeling emotionally numb, sudden outbursts of anger, and being upset by minor things that don’t upset most people.
While a full diagnosis of PTSD after a breast cancer diagnosis was rare, a German study has found that 82.5% of women diagnosed with early-stage disease had symptoms of PTSD between the time they were diagnosed and the start of treatment. The research was published online on Feb. 22, 2016 by the journal Psycho-Oncology. Read the abstract of “Clinically assessed post-traumatic stress in patients with breast cancer during the first year after diagnosis in the prospective, longitudinal, controlled COGNICARES study.”
The study included 166 women age 65 or younger who had been recently diagnosed with early-stage breast cancer. Over the next year, the researchers evaluated the women for PTSD symptoms three times:
- after diagnosis but before treatment started
- after chemotherapy was completed
- 1 year after diagnosis
The results were compared to a control group of 60 women who hadn’t been diagnosed with breast cancer.
At the first PTSD evaluation, before treatment started, 82.5% of the women in the study had one or more PTSD symptoms. The average number of PTSD symptoms was 3.1. Still, only six women (3.6%) received a full diagnosis of PTSD.
One year after diagnosis, 57.3% of the women were still having PTSD symptoms, though the average number of symptoms had dropped to 1.7. The number of women with a full diagnosis of PTSD dropped to three women (2.0%).
"That the high level of stress should persist for such a long time is particularly striking," said Dr. Kerstin Hermelink, of the Ludwig-Maximilians Universitat Breast Cancer Center, who was the lead author of the study.
None of the women in the control group received a PTSD diagnosis, and only 18% of the women had any PTSD symptoms. The average number of symptoms in the control group was 0.4.
The researchers also looked to see if certain factors affected whether a woman would have PTSD symptoms or not after being diagnosed with breast cancer.
"Neither the type of surgery nor receipt of chemotherapy had any significant effect on either of these variables, but a high level of education did have a favorable impact," said Dr. Hermelink. "A university education is evidently a marker for resources that enable patients to recover more rapidly from the psychological stresses associated with a diagnosis of breast cancer."
While the results of this study are troubling, there is some good news. The PTSD symptoms did ease over time for many women: the number of women with PTSD symptoms dropped about 25 points from the first evaluation to the third. Also, this study may help raise awareness that women newly diagnosed with breast cancer are at risk for PTSD symptoms. Identifying women who develop PTSD symptoms soon after a breast cancer diagnosis would likely help them get the support and treatment they need.
If you’ve been newly diagnosed with breast cancer, you may feel like your emotions are on a rollercoaster, swooping from scared to stressed to worried to angry all in a few minutes' time. So what separates “normal” stress from PTSD symptoms? PTSD symptoms last longer than a month and severely affect your daily life. Symptoms include:
- nightmares or flashbacks about the cancer experience
- continuously focusing on the cancer experience
- extreme irritability
- feeling emotionally numb
- loss of appetite
- self-destructive behavior (alcohol or drug abuse, for example)
- being startled or frightening easily
- memory problems
- concentration problems
To make sure you get the help you need, talk to your doctor right away if you’re having PTSD symptoms. Treatment for these symptoms can include medicines, such as antidepressants, and therapy to help you learn ways to cope with situations that may trigger traumatic stress.
For more information on PTSD symptoms and tips to manage PTSD brought on by a breast cancer diagnosis, visit the Breastcancer.org PTSD page.