Kids with cancer are tougher than you’d think.
For a long time, it has been widely believed that children who have had cancer have a high likelihood of developing post-traumatic stress disorder (PTSD), an assumption that has been reinforced by research. One study found that as many as one-third of childhood cancer survivors develops PTSD.
But a team of researchers at St. Jude’s Children’s Research Hospital in Memphis, TN, thought otherwise.1 They noticed that, in most studies that found high rates of PTSD in childhood cancer survivors, the interviews focused on the subjects’ cancer because it was assumed that cancer would be the most traumatic event in the child’s life. This may have biased the results by causing the subjects to recall their cancer experience while reporting their mental state.
“We know such suggestions, called ‘focusing illusions’, prime individuals to think about their cancer experience as traumatic and leaves them prone to exaggerating its impact in subjective reports,” said lead researcher Sean Phipps, PhD, chair of the St. Jude Department of Psychology.
The Answers You Get Depend on the Questions You Ask
The St. Jude’s team administered a structured diagnostic interview on PTSD symptoms and traumatic life events to 255 pediatric cancer survivors between 8 and 17 years of age, along with 101 control subjects with no history of cancer. To prevent focusing illusion, the researchers allowed the subjects themselves to identify their most traumatic life event, without being prompted about cancer.
Surprisingly, only about half the patients identified a cancer-related event as their most traumatic life experience. As time since diagnosis increased, the likelihood of naming a cancer-related event as their most traumatic experience decreased.
Only seven of the cancer survivors (2.8%) met criteria for lifetime occurrence of PTSD, and of these, only two cases were cancer-related. Just one child had PTSD at the time of the study. No cases of PTSD were found among the controls.
As if cancer wasn’t enough for one lifetime, some of the patients had experienced even more traumatic life events, including evacuation from hurricane Katrina, homelessness, the unexpected death of family members, and a drive-by shooting.
Parents were more likely than their children to call cancer the most traumatic event in the child’s life, and more likely than their children to identify symptoms of PTSD—based on parent interviews, 15 patients with cancer (5.9%) and two control subjects (2.0%) had PTSD.
Making the Best of a Bad Situation
Most significantly, many childhood cancer survivors reported that they had benefited from the experience as it allowed them to develop empathy or grow closer to family and friends.
“These results should be very reassuring to childhood cancer patients and their families,” Dr. Phipps said. “A cancer diagnosis is a highly significant and challenging event, but this study highlights the impressive capacity of children to adjust to changes in their lives and, in most cases, do just fine or even thrive emotionally as a result.”
- Phipps S, Klosky JL, Long A, et al. Posttraumatic stress and psychological growth in children with cancer: has the traumatic impact of cancer been overestimated? J Clin Oncol. 2014 Jan 21. [Epub ahead of print] http://jco.ascopubs.org/content/early/2014/01/21/JCO.2013.49.8212.