Post-Traumatic Stress Disorder Related to the Cancer Experience
Post-Traumatic Stress Disorder Related to the Cancer Experience
Many healthcare professionals think about PTSD in the context of soldiers returning from war zones, victims of abuse, or trauma survivors. Beginning in 1994, PTSD also was applied to patients with cancer when the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) (DSM-IV) redefined trauma criteria to include life-threatening illness such as cancer (American Psychiatric Association [APA], 2000). Many oncology nurses may be surprised by the prevalence and severity of PTSD in cancer survivors.
After many years of experience as an oncology nurse and with a specialty in clinical psychology, I was now one of the patients. A routine appendectomy revealed a 5 cm tumor diagnosed as stage II ovarian cancer. Scans found a breast mass that turned out to be a stage I breast cancer. Surgeries to treat both would be followed with six cycles of paclitaxel and carboplatin and seven weeks of radiation therapy. I felt like I was in a nightmare. How could this be happening to me? What about my job as a nurse practitioner working with patients with breast and ovarian cancer? I will lose my hair! How will this affect my family after years of prior stressors? Can I face the challenge with the courage of my patients who, throughout my career, have taught me the values of hope and resilience?
Introduction
I wasn't sure if it was a question or a statement, but when a family member commented, "It is the one-year anniversary of your cancer diagnosis. You must feel better," I found myself comforting her by replying, "Yes, I feel better." In reality, I felt worse. It was five months after my treatment ended and I still couldn't find myself. Was I even the same self? This is when I understood that I was experiencing a form of post-traumatic stress disorder (PTSD) after my diagnosis and treatment for ovarian and breast cancer.Many healthcare professionals think about PTSD in the context of soldiers returning from war zones, victims of abuse, or trauma survivors. Beginning in 1994, PTSD also was applied to patients with cancer when the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) (DSM-IV) redefined trauma criteria to include life-threatening illness such as cancer (American Psychiatric Association [APA], 2000). Many oncology nurses may be surprised by the prevalence and severity of PTSD in cancer survivors.
After many years of experience as an oncology nurse and with a specialty in clinical psychology, I was now one of the patients. A routine appendectomy revealed a 5 cm tumor diagnosed as stage II ovarian cancer. Scans found a breast mass that turned out to be a stage I breast cancer. Surgeries to treat both would be followed with six cycles of paclitaxel and carboplatin and seven weeks of radiation therapy. I felt like I was in a nightmare. How could this be happening to me? What about my job as a nurse practitioner working with patients with breast and ovarian cancer? I will lose my hair! How will this affect my family after years of prior stressors? Can I face the challenge with the courage of my patients who, throughout my career, have taught me the values of hope and resilience?
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