The hidden scars of cancer

Families struggle with post-traumatic stress


Just like a soldier returning from battle may experience post-traumatic stress, so too can the loved ones of cancer patients. The life-threatening diagnosis can leave families living in intense fear, overwhelmed by a sense of helplessness, and avoiding people or places that trigger bad memories.

When 12-year-old Sammy Bradly began falling asleep at baseball practice, he knew something was wrong.

"I just wasn't feeling the same. I didn't feel like me," Sammy said.

He was diagnosed with AML Leukemia.

"Honestly I pretty much fell to my knees and blacked out," said Annie Bradly, Sammy's mom.

He endured six months of chemo.

Sammy said, "I met a lot of people in the hospital and I was the only one to walk away alive," including losing his best friend Noxah to cancer.

"He was the only person I knew that would understand how I felt," Sammy said.

Four years now in remission, the experience has not been forgotten.

"I know that these guys don't know, but there are days where I just start crying for no reason at all," Annie explained.

Intense fear still plagues Sammy's mom.

"What do I do? We're okay, but are we okay?" Annie said.

Dr. Anne Kazak says these traumatic stress symptoms are more common in parents than people know.

"It might be bad dreams or nightmares. It might also just be that you're walking down the street and all of the sudden you are back in that moment," explained Kazak, who is a Pediatric Psychologist with  Nemours/Alfred I. duPont Hospital for Children.

One study of 171 mothers and fathers of cancer patients found all but one had post-traumatic stress, closely related to PTSD; something Kazak says affects about one in three parents.

She says her best advice is to focus on what you can control.

"It's almost never helpful to worry too much in advance," Kazak said.

Also,Kazak recommends finding support.

"Reflect on the fact that you are in a war against cancer," she explained.

It is a fight Sammy's family accepts.

"It's just a huge part of who I am today," Sammy said.

There are things that parents can do to help with traumatic stress symptoms. Relaxation techniques such as visualization, deep breathing, yoga, and meditation may be helpful.

Both healthcare professionals and parents looking for information about medical trauma can log onto healthcaretoolbox.org.

Additional Information:

When in danger, a person's natural response is to be afraid.  This fear triggers many changes in the body to prepare to defend against the danger or to avoid it, which is a healthy reaction. However, in post-traumatic stress disorder (PTSD), this reaction is damaged or changed.  People who have PTSD may feel stressed or frightened even when they are no longer in danger.  PTSD develops after a terrifying experience that involved physical harm or the threat of harm. The person who develops PTSD may have been the one who was actually harmed, the harm may have occurred to a loved one, or the person may have witnessed a harmful event that happened to strangers or loved ones.  (Source: nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml)

PTSD & CANCER SURVIVORS: Some survivors of cancer experience trauma-related symptoms similar to symptoms experienced by someone who has survived a very stressful situation, and are considered at risk for developing PTSD. The mental and physical shock of having a life-threatening disease, living with repeated threats to one's body and life, and receiving treatment are all traumatic experiences for many cancer patients. For the person who has experienced a diagnosis of cancer, the specific trauma that triggers PTSD is unclear.  Learning that one's child has cancer is traumatic for many parents.  Because a diagnosis of cancer can involve many upsetting situations, it is much more difficult to single out one event as a cause of stress than it is for other traumas, like rape or a car accident.  The traumatic event may cause responses of extreme fear, helplessness, or horror and may trigger PTSD symptoms.  PTSD in cancer survivors may be experience these specific behaviors: being continuously overexcited, irritable, fearful, and unable to sleep; reliving the cancer experience in nightmares or flashbacks and by continuously thinking about it; or avoiding events, places, and people connected to the cancer experience. To be diagnosed as PTSD, these symptoms must last for at least one month and cause major problems in the patient's life.  (Source: cancer.gov/cancertopics/pdq/supportivecare/post-traumatic-stress/Patient/page3)

TREATMENT: Effects of PTSD are long-lasting and serious.  It could affect the patient's ability to have a normal life and may interfere with personal relationships, employment, and education.  It is important that cancer survivors receive information about the possible psychological effects of their cancer experience.  Therapies used to treat PTSD are those used for other trauma victims.  The crisis intervention method tries to lessen the symptoms and return the patient to a normal level of functioning. Therapists focus on teaching coping skills, solving problems, and providing a supportive setting for the patient. Some patients benefit from methods that teach them to change their behaviors by changing their thinking patterns. For patients with severe symptoms, medications can be used, such as antianxiety medications, antidepressants, and when necessary, antipsychotic medications. (Source: cancer.gov/cancertopics/pdq/supportivecare/post-traumatic-stress/Patient/page6)