Breast cancer: diagnostic shock has a long lasting effect

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Getting diagnosed with breast cancer is a traumatic experience. In many patients, the shock lingers for a long time. For a year after the diagnosis, they still suffer from psychological symptoms that are typical of post-traumatic stress disorder. For example, their thoughts are constantly revolving around the condition, feeling emotionally numb or irritable, prone to outbursts of anger, or being overly jumpy.

Dr. Kerstin Hermelink from the Breast Cancer Center at the University of Munich and her doctoral student Varinka Voigt provided scientific support to more than 160 breast cancer patients over a period of one year. During this time, they examined the participants three times using psychological questionnaires for signs of post-traumatic stress.

Still suffering after a year

Before treatment was started, 82.5 percent of all patients had symptoms of this kind. A year later, more than half (57.3 percent) were still suffering from post-traumatic symptoms. Two percent had developed fully developed post-traumatic stress disorder (PTSB). "It is remarkable that the high emotional stress caused by the disease persists over such a long period of time," says Hermelink.

How much the cancer diagnosis shook the women is also shown by the following comparison: Of the patients who had already experienced trauma before their illness and diagnosis - such as a serious accident or a violent attack - 40 percent thought the diagnosis of breast cancer was the worse experience.

Education protects against trauma

The researchers have not yet been able to clarify why some patients are spared post-traumatic stress symptoms and why others suffer from them for a particularly long time. The type of surgery or chemotherapy does not seem to have any influence on this. However, more educated women tended to recover more quickly from the shock of diagnosis.

The study results contradict the currently valid guidelines for psychiatric diagnoses, DSM. Since 2013, life-threatening illnesses are no longer listed as potential triggers for trauma. Psycho-oncologist Hermelink: "Against the background of our study results and my experience from working with breast cancer patients, I think that's wrong." Rather, doctors should be prepared for the fact that after a breast cancer diagnosis, the majority of patients develop post-traumatic stress symptoms and require appropriate support. (cf)

Varinka Voigt et al .: Clinically assessed posttraumatic stress in patients with breast cancer during the first year after diagnosis in the prospective, longitudinal, controlled COGNICARES study, Psycho Oncology, 22 FEB 2016, DOI: 10.1002 / pon. 4102

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