Majority Of Breast Cancer Patients Experience Post-Traumatic Stress Symptoms After Diagnosis

June 26, 2023; Unhurry Expert Research Team

Most people who are diagnosed with breast cancer go on to experience post-traumatic stress disorder symptoms, which often last for at least a year according to research.

In the months after receiving the diagnosis, most breast cancer patients experience post-traumatic stress symptoms. According to the most recent findings of the Cognicares study, which was directed by Dr. Kerstin Hermelink of the Breast Cancer Centre in the Department of Gynaecology and Obstetrics at the LMU Medical Centre, such symptoms can still be identified a year after patients have been notified of their disease. The journal Psycho-Oncology has published the most recent findings.

Kerstin Hermelink and Varinka Voigt, a PhD student, examined 166 patients with newly discovered breast cancer as part of the multicentre Cognicares trial. The presence of clinically significant post-traumatic stress disorder (PTSD) symptoms was evaluated in the subjects three times throughout the course of the subsequent year. The outcomes were then contrasted with a control group of patients who had not been given a cancer diagnosis.

What is PTSD?

A person may undergo or witness a horrific or horrifying event where there was substantial bodily pain or threat, and this can result in post-traumatic stress disorder (PTSD), sometimes known as shell shock or battle fatigue syndrome. Traumatic experiences that leave people feeling incredibly terrified, helpless, or horrified can lead to PTSD. Sexual or physical abuse, the unexpected loss of a loved one, an accident, a war, or a natural disaster are a few examples of events that might cause PTSD. Emergency responders and rescue workers, as well as victims’ families, are all susceptible to PTSD.

82.5% of cancer patients exhibit symptoms of PTSD

82.5% of all cancer patients were found to have PTSD symptoms between the time of diagnosis and the start of treatment, including frequent and bothersome flashbacks to the cancer-related events, feelings of emotional numbness and detachment, increased arousal, sudden outbursts of rage, and an exaggerated startle response.

Only 2% of patients had a full diagnosis of PTSD one year after receiving a cancer diagnosis, but more than half (57.3%) were still exhibiting one or more symptoms of the condition at that time.

In contrast, the rate of PTSD symptoms due to other traumatic events was very low in the controls and the patients alike. “That the high level of stress should persist for such a long time is particularly striking,” says Kerstin Hermelink. Indeed, the severity of the psychological and emotional impact of the cancer diagnosis is underlined by another result reported in the study.

Cancer a traumatic event

About 40% of patients who had experienced trauma before developing cancer—such as a significant accident or a violent assault—rated getting breast cancer as the trauma they had experienced that was the most traumatic.

“Cognicares is one of the very few longitudinal studies of traumatic stress associated with breast cancer,” says Hermelink. Additionally, rather than using self-reports, the study’s results were obtained from diagnostic interviews with psychologists. Women with a history of psychiatric illness were not allowed to participate in the trial, only patients who were clear of metastatic disease and could thus hope to be permanently cured. “Indeed, we assume that the study is likely to somewhat underestimate the true incidence of post-traumatic stress symptoms in breast cancer patients,” Hermelink adds.

Influencing factors for PTSD symptoms

The researchers also set out to identify factors that could account for the varying incidence and the varying duration of symptoms of PTSD among their study population. “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 favourable impact. 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,” Hermelink explains.

The results of the study also raise questions regarding the decision of the editors of the latest (2013) edition of the “Diagnostic and Statistical Manual of Mental Disorders” (which serves as the major source of diagnostic guidelines in the field of Psychiatry) to remove the factor ‘life-threatening disease’ from their list of potential inducers of trauma. “In light of the results of our study, and against the background of my own experience as a psycho-oncologist with breast cancer patients, I regard this decision as highly questionable,” says Hermelink. “Doctors should be made aware of the fact that the majority of breast cancer patients develop symptoms of post-traumatic stress subsequent to diagnosis and need to receive the appropriate support.”

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Story Source:

Materials provided by Ludwig-Maximilians-Universitaet Muenchen (LMU). Note: Content may be edited for style and length.

Journal Reference:

Varinka Voigt, Franziska Neufeld, Judith Kaste, Markus Bühner, Philipp Sckopke, Rachel Wuerstlein, Karin Hellerhoff, Anikó Sztrókay-Gaul, Michael Braun, Franz Edler von Koch, Eliane Silva-Zürcher, Stephan Hasmüller, Ingo Bauerfeind, Gerlinde Debus, Peter Herschbach, Sven Mahner, Nadia Harbeck, Kerstin Hermelink. Clinically assessed posttraumatic stress in patients with breast cancer during the first year after diagnosis in the prospective, longitudinal, controlled COGNICARES study. Psycho-Oncology, 2016; DOI: 10.1002/pon.4102

Page citation:

Ludwig-Maximilians-Universitaet Muenchen (LMU). “Breast cancer: The mental trauma of severe disease.” ScienceDaily. ScienceDaily, 2 March 2016. <>.

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