Persistence of PTSD Highlighted in Large NHL Survivor Study

A survey of more than 500 long-term survivors of non-Hodgkin’s lymphoma (NHL) has revealed that more than one-third experience persistent or worsening symptoms of post-traumatic stress disorder (PTSD), with nearly 4 of 10 cancer survivors stating they still experience symptoms of PTSD more than a decade after their cancer diagnosis. The study was published online first on October 12, in the Journal of Clinical Oncology.

Brain structures involved in dealing with fear and stress.

The study authors, from Duke University, UNC Chapel Hill, and UCLA, concluded that “providers should be aware of enduring risk” of PTSD among cancer survivors. Sophia K. Smith, PhD, from Duke University Medical Center, is lead investigator.

For the study, the investigators mailed surveys to 682 NHL survivors who had participated in an earlier survey and were 7 or more years post diagnosis. The survey asked participants about PTSD symptoms, their perceptions about the cancer experience (the positive and negative impact of cancer), and other potential correlates of PTSD.

A total of 566 survivors participated in the survey. More than half (52%) were female and the majority (87%) were white. Median time since diagnosis was 12.9 years. About half (51%) of the respondents reported no PTSD symptoms and 12% reported a resolution of symptoms, but over one-third (37%) said their symptoms had persisted or worsened over 5 years. At follow-up, Dr. Smith and coauthors wrote, more PTSD symptoms were reported by survivors who in the initial survey reported the following: a low income, stage II or higher disease at diagnosis, aggressive lymphoma, chemotherapy treatment, and greater impact of cancer (positive as well as negative). Income and negative impacts of cancer were independent predictors of PTSD symptoms in a multivariate analysis.

In conclusion, the authors wrote that their findings suggest long-term psychological outcomes in cancer survivors can possibly be improved through healthcare provider “early identification of those at prolonged risk with standardized measures and treatments that target perceptions of the cancer experience.”