Around one in 30 Americans is presently receiving treatment for cancer or has done so in the past. The road to recovery is stressful for cancer patients, who must fight their way through the powerful emotions associated with having a life-threatening disease. Stress triggers the automatic fight – flight – freeze reactions hardwired into our brains, which floods us with feelings of anger, anxiety or depression.
A significant proportion of cancer patients struggle to manage these negative emotions and their psychological suffering can equal the physical discomfort they also endure. Even when they survive the cancer, they struggle with post-traumatic stress symptoms for years after their treatment has ended.
People with PTSD find that certain events set off distressing recollections of their past problems, and they go to great lengths to avoid those activities, people, or places. But that causes them to become detached from others and diminishes their interest in pleasurable activities. They develop a foreboding feeling about their future that casts a pall over their entire life. They have trouble sleeping, concentrating, and relaxing. Their mood is often irritable, and angry outbursts are common.
PTSD symptoms frequently occur in the month leading up to a follow-up visit to the oncologist. Nine out of 10 patients are afraid that their cancer will reoccur, and going in for a checkup can cause bouts of anxiety leading to disturbed sleep and increased irritability. The actual visit to the medical facility with all of the associated sights and smells is enough to prompt feelings of panic in some patients.
Cancer patients frequently find that they become extremely vigilant about their health, scanning their body for symptoms and reacting strongly to the slightest sign of a problem.
Many worry about having lost their energy, and over a third of patients report increased levels of fatigue 5 – 10 years after treatment. Typically it takes a month for patients to recover their previous energy level for every month of treatment they have undergone. But many patients become discouraged, even depressed, and struggle to resume their normal lifestyle.
Studies of cancer survivors have found that stress is prevalent for patients during transitions. In particular, the most stressful time has been found to occur just after an intense phase of their cancer treatment. This is surprising to most people, as patients, family and friends alike expect that completing weeks or months of grueling medical procedures will offer relief, especially if the prognosis is favorable.
In reality what happens is that the patient loses much of the support and structure they were receiving from their treatment team and other patients. Family and friends assume that the worst is over and expect the patient to return to normal in short order. Most people fail to appreciate the lingering effects on patients who have gone through such a traumatic physical and emotional experience.
Researchers have found that cancer patients typically feel additional anxiety, heightened vulnerability, and more uncertainty about their future during the period immediately following treatment. Of course that’s just when they’re most exhausted as a result of having had to muster all of their physical and psychological strength to suffer through various medical procedures.
In addition, many patients have problems with concentration, memory, and attention for months following their chemotherapy treatment – a syndrome often referred to as “chemo brain”. This impairment in their ability to think clearly makes it hard for them to figure out successful strategies for coping with their stress, leaving them susceptible to developing PTSD.
The Harvard Mental Health Letter recently reported on two high quality research trials that revealed that exercising both the mind and body can appreciably improve the quality of life for patients following an intense cancer treatment. Regular aerobic exercise and strength training helped to alleviate fatigue and improved physical functioning.
Cognitive Behavioral Therapy was shown to significantly improve the coping skills of cancer patients. Patients who learned self-help strategies found their distress was diminished during transitions and their life was considerably more enjoyable than a control group who did not receive CBT. And these positive results were still in place when the psychologists followed up with patients 20 months after their psychotherapy had ended.
Cancer is a disease that not only threatens people’s lives, but one that can forever affect their wellbeing. But it’s also possible for survivors to learn that facing such a formidable disease has built their resilience skills, ultimately giving them greater confidence and self-respect. They feel happy to be alive and have a deeper appreciation for day-to-day life.