Adult survivors of childhood cancer are four times as likely as their siblings to suffer post-traumatic stress disorder, UCLA researchers reported Monday. About 9% of the adults suffer PTSD, characterized by increased physiological activity, phobias, startling easily, being hyper-vigilant, being on edge, suffering extreme anxiety and avoiding reminders of their cancer diagnosis and treatment, the researchers found. In contrast, only 2% of their siblings suffered similar problems.
"Childhood cancer survivors, like others with PTSD, have been exposed to an event that made them feel very frightened or helpless or horrified," Dr. Margaret Stuber, a UCLA psychiatrist who led the study, said in a statement. "This study demonstrates that some of these survivors are suffering many years after successful treatment."
Stuber and her colleagues studied 6,542 adults over 18 who were diagnosed with cancer between 1970 and 1986, as well as 368 of their siblings. They reported in the May issue of the journal Pediatrics that 589 of the survivors suffered from PTSD, compared with eight of their siblings.
Other recent studies have looked at PTSD in victims of childhood cancer and found an incidence of only about 3% while they are still children or adolescents. The discrepancy might arise because more recent treatments are less traumatic and employ less brain irradiation than earlier work, Stuber said. Or it might be that the clinical distress and functional impairment only emerge with the added stress of such adult challenges as completing their education, finding a job, getting health insurance, establishing intimate relationships and starting a family.
"These survivors may find they can't get health insurance," Stuber said. "They may be reluctant to put themselves on the marriage market because they're sterile. Those that can have children may be afraid of passing their 'bad genes' on to their children. Some treatments affect growth, so some survivors may be shorter and heavier than their peers. They may feel like they are damaged goods."
The study, funded by the National Cancer Institutes, looked at all types of childhood cancer and found that the likelihood of PTSD increased with more intensive treatments.
-- Thomas H. Maugh II