Jamie Reno (@jamiereno) published a blog post · November 12th, 2013

PTSD Common for Soldiers and Cancer Patients

war is hellMy heroes have always been war veterans. And cancer patients. When you think about it, the two groups have a lot in common.

Recently, I interviewed a Marine combat veteran who'd endured four tours of duty in Afghanistan. This guy had seen one of his best buddies killed in an improvised explosive device (IED) blast.

But when he learned that I’d been through four battles with stage IV non-Hodgkin's lymphoma, he asked me how I made it through.

I just shook my head in amazement and said, “It was absolutely nothing compared to what you must have gone through in combat, seeing your friends die and getting shot at.”

He said in all sincerity that he could easily handle being in a war better than going through cancer treatment.

I told him I never wanted to find out which “fight” is tougher. We shared a laugh. And at that moment I was reminded, again, how much war veterans and cancer patients do indeed share.

I respect and admire every man and woman who puts on a uniform and fights for our country, and every man, woman and child who's been diagnosed with and fights cancer.

We fight very different battles, of course, but cancer and war, which are both fitting metaphors for the other, bring out the best, and worst, in us.

Both are ultimate tests of our strength, courage, and love for life.

Both can be pure hell.

And both can cause deep and lasting psychological trauma.

Last year, I reported for The Daily Beast that about one in three veterans of the fighting in Iraq and Afghanistan suffer from Post-Traumatic Stress Disorder (PTSD), which is a form of anxiety that develops in reaction to physical injury or severe mental or emotional distress, such as military combat, violent assault, natural disaster, or other life-threatening events.

It is widely known that PTSD is common among our troops and veterans. But what is less commonly known is that it’s also very common among cancer patients.

Researchers in the February 2013 Journal of the National Cancer Institute confirm that nearly one in four newly diagnosed breast cancer patients often start manifesting symptoms of PTSD shortly after hearing the words, “You have breast cancer.”

According to the National Cancer Institute, the physical and mental shock of having a life-threatening disease, of receiving treatment for cancer, and living with repeated threats to one's body and life are traumatic experiences for many cancer patients that can often lead to PTSD.

I've never been formally diagnosed with PTSD. But I know I have it. No question about it.

I still sometimes have nightmares about my cancer. And I still have a hard time even driving by the hospital where I had my initial chemotherapy. It triggers a lot of emotions within me. Fear, especially, and anger.

The way I see it, every cancer patient has some form of PTSD. It typically is not as severe in cancer patients as it often is for war veterans. But it is very real.

But what matters is that for all the trauma that accompanies fighting cancer, and fighting wars, they also both give us an immeasurable appreciation for the precious gift that is this life.

That old cliché’ is true, you know: What doesn’t kill us really does make us stronger!

Blog breast-cancer Cancer Battle Cancer Survivor chemotherapy Combat Jamie Reno National Cancer Institute non-Hodgkin's Lymphoma Post-Traumatic Stress Disorder PTSD The Daily Beast Veterans Day War

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sharon (@sharonp) · Nov 12, 2013 · #

I cannot tell you how glad I am that you have reported the PTSD in cancer patients as well. Very little has been written about it for those who experience a life-threatening disease. As someone who has PTSD herself, I recognized it in my daughter while she was treated for cancer and realized how utterly traumatic diagnosis, treatment and SUFFERING were to her and are to patients. Even caregivers for sick family members can be traumatized. Anytime one comes close to death and loss by violence, surgery, disease, etc. we are rewired. The brain resets into the fear and vigilance mode.Once you come close to death, anything is possible. I know it well. Cancer treatment can be ravaging in many ways.

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Jamie Reno (@jamiereno) · Nov 12, 2013 · #

Thanks very much, Sharon. This is something that really hasn't gotten enough attention in the media. But every cancer patient I've ever met knows about anxiety and fear. Obviously we all deal with it differently.

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craigandme (@craigandme) · Nov 13, 2013 · #

THANKS SHARON FOR RECOGNIZING THAT CAREGIVERS ARE TRAUMATIZED AS WELL AS THE PATIENT. I WAS A FULL-TIME CAREGIVER FOR MY SON WHO LOST HIS BATTLE IN APRIL 2012. I STILL FEEL I AM IN MELTDOWN. THIS PROFOUND KIND OF LOSS IS UNBEARABLE ....

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sharon (@sharonp) · Nov 13, 2013 · #

I am so sorry about your son. It *is* truly unbearable to watch your child
suffer and as parents, not be able to relieve it, then lose him. I believe
the trauma begins with diagnosis - the *news*... because the idea that he
or she could die is profoundly shocking.The brain can't process it
rationally. It's like living in an alternate state, a parallel universe to
the world you once inhabited. There are few words that can truly describe
the loss of a child. We are forever changed, but we are not alone,
unfortunately. I wish you peace. You have been through so much and one year
feels like one day.

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racook (@racook) · Nov 14, 2013 · #

llschulte72 (@llschulte72) · Nov 15, 2013 · #

I am happy as well that you've written this. War veterans, soldiers, cancer patients. I would also add caregivers/parents of children diagnosed. We "expect" adults to get diseases to a degree, or at least it may be "easier" to rationalize (and I use quotes because NONE of it is easy or expected), but to see children of all ages have to go through it is horrific. My son had a relatively smooth time getting through treatment, but there were many we knew that did not. Babies, toddlers, elementary age children. As a mother of a cancer survivor, I have dreams of my son dying and not being able to save him, I have anxiety whenever he goes in for scans with the fear that it may return, and am overall angry that he cannot play some sports he loves because of post treatment side effects. At any rate, this was an excellent analogy. Thank you.

racook (@racook) · Nov 15, 2013 · #

Yes, I agree. My son was diagnosed at 16 and at 18 passed away. I worry daily about my daughter. I lose sleep, every pain or ache becomes life or death in my head. The roller coaster of watching the progression of cancer is unbearable for both the patient and care giver !! The one more procedure and than another failure is heart breaking. I often wonder how long it will be become life seems manageable again. I believe, as a direct result of two years of treatment and the death of our son, it plays a large part in our divorce after 25 years of being together. The toll is high!!

Andy Anderson (@andydonegal) · Nov 12, 2013 · #

I was formally diagnosed with PTSD - it struck about six months after the 'umbilical cord' connecting me to the hospital was severed with the words "We'll see you in three months!" and I was 'thrown out' into the world to try to regain some sort of normality and make sense of the past ten months. In hindsight it was an interesting experience, at the time it was hell!!! The 'Welcome Back' to work was wonderful, but since my colleagues had no and could have had no understanding of where I was the 'leniency' of the first day back didn't last long ... and, frankly, I couldn't cope with the pressures and a cared less about the work. It was a long slow process, one complicated by an unrecognised lack of testosterone - I won't say 'undiagnosed' because I had diagnosed it six months after treatment ... it took the medical profession another four and a half years to catch up with me!!!!!

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Andy Anderson (@andydonegal) · Nov 12, 2013 · #

I could add that, thankfully, I was stubborn enough to seek assistance - "Why should I go on suffering alone when there's help available just up the road?" I went back to the hospital and sought assistance. After a lengthy consultation they eventually asked, hesitantly, "If we make an appointment would you be agreeable to seeing a psychiatrist?" Me need a psychiatrist? How DARE they!!!! I am perfectly sane!!!! Well, good sense prevailed. What had I to lose? Absolutely nothing! And if I didn't like what the psychiatrist said I could dismiss it!!!! I agreed.
I went back to work, sat at my desk, and typed "Having cancer SUCKS!!! It REALLY SUCKS!!!" and it all just started to flow. At times I couldn't keep up with the flow, but after two days and 27,600 words ... the entire cancer experience; my opinions, both good and bad; absolutely EVERYTHING was on my computer - and I felt WONDERFUL, cleansed, restored, whatever you want to call it.
Interesting that when I eventually saw the psychiatrist, a Professor no less, what I had accidently done in my 27,000 words was one of his strategies for effecting a 'cure'.
It's the exercise of writing, not the writing itself; it's a unique kind of writing in that there is no expected audience. I wasn't writing for someone to read my words - my mental filing cabinet was sitting there with the drawers open and the files and papers strewn across the floor, all the mental filing that had been neglected because I was using my emotional and physical energy simply to survive - all my furious typing was, in effect, a process of sorting out the papers, putting each paper into its correct file, putting each file into its correct drawer and closing the cabinet.
I printed off a copy and copied the file to disk ... both disk and paper copy went home and were put away [at the bottom of the underwear drawer] unread; and there they remained for several years. They saw the light of day again only because one of my nurses was doing his doctoral thesis and asked to interview me about my experience.
It's a hell of a therapy for PTSD .... but it's one that really works - at least it did for me!!!

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Jamie Reno (@jamiereno) · Nov 12, 2013 · #

Thanks Andy. I am so glad this helped you. I can personally relate to the power of writing out your feelings. It has really helped me throughout my 17-year cancer journey.

carol (@tharootunian) · Nov 13, 2013 · #

I'm just really enjoying this conversation. I started to write out of a kind of immobilizing frustration fueled by a tsunami of anger. Not about the cancer but about the system. I never did feel victimized by the cancer. It happened. It then became my new job to get it together and deal with it. There were choices to make, information to gather, unreadable articles to try to understand, drugs that had hundreds of words of warnings including death to learn about. Everything I could understand would be a survival tool.
The system is another story and one that has inspired me to write just so I don't go nuts.
And out of the writing came an unexpected gift. Humor. 3 a.m. in the morning and I would be laughing out loud at some unbelievable tale, trying to find words to do justice. It was some kind of unconscious wisdom that helped to transform the anger through the magic of humor to resolution. Finding my way through the medical system has been and continues to be gauntletesk. I have received such bad, wrong, untrue and whacky advise that even in a state of being almost dead I knew better than to believe. I have also been given advise that saved my life. Knowing the difference and making the best decision for myself has been my survival strategy. It feels like searching for the golden key. There is no doubt, people with cancer are warriors, the bravest of whom are the children. Let there be a cure.
I hope you all have a wonder filled day.

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sherrik (@sherrik) · Nov 13, 2013 · #

How everything has changed for my sister and all of her loved ones (including me) in the last 2 1/2 years has finally been verbalized. The PTSD has affected us all, but I could never put a name to it until now. Thanks for validating this phenomenon-just thinking about it in a new light has a cleansing effect.

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Jamie Reno (@jamiereno) · Nov 13, 2013 · #

Great post, thanks so much for sharing that. I think just about everyone who reads your comments will be able to relate to your experience as a cancer patients, from the good and bad advice you have gotten to the importance of humor. Let there be a cure, indeed!

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Cancer2x (@cancer2x) · Nov 13, 2013 · #

As a Vietnam combat vet, heavy combat, and a cancer patient with two different primary cancers, multiple surgeries, and now advanced incurable cancer, I am quite sure that if PTSD is a real thing, I must surely have it. Nobody has ever mentioned the possibility of this other thing to deal with, or what to do about it, if anything. Seems to be some sort of connection between the two though.

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Jamie Reno (@jamiereno) · Nov 13, 2013 · #

You are a very courageous person. Thanks for your service to our country!