Posttraumatic Stress Disorder and Cancer: Some Interesting Similarities and Differences

Over the past 2 decades, there has been significant research on the diagnosis and treatment of posttraumatic stress disorder (PTSD) in U.S. service members and veterans. Despite considerable progress, a number of challenges have limited these advancements. In contrast, over the past 7 decades, the field of cancer has been a model of significant advancements and overcoming clinical and research barriers. This article reviews the similarities and differences between clinical and research approaches to cancer and PTSD and how the field of cancer might serve as be a roadmap for advancing PTSD research. Related to diagnosis, there are now more than 200 types of cancer that are classified according to where they start in the body and the type of cells that are involved. In contrast, although PTSD can result from exposure to many different types of trauma, there is currently only one type of PTSD according to published diagnostic guidelines. More research funding has been dedicated to cancer than probably any other medical condition. As a result, more advancements have been made in the diagnosis and treatment of cancer than perhaps any other condition. Clinical trials for PTSD have been ongoing for about half as long as cancer. The findings from initial PTSD clinical trials in military populations were criticized because of poorer treatment outcomes compared to civilians. Although recent trials have achieved better outcomes, the successful approach to cancer treatment may help guide future clinical and research approaches to the treatment of PTSD. Patients in cancer clinical trials are provided with informed consent outlining the potential risks and benefits of treatment. Despite the significant side effects of cancer treatments, most patients pursue one or more rounds of treatment. Participants in PTSD trials also complete informed consent. However, the lack of systematic adverse event monitoring has resulted in limited data on side effects. This may contribute to high drop-out rates with PTSD treatments even though the risk of side effects is minor compared to cancer. For many decades, there was significant stigma associated with the diagnosis of cancer. Much of this stigma has now been reduced with improved cancer treatments and public health campaigns. In contrast, significant stigma continues to exist with PTSD, especially among military service members. Considerable clinical, research, and public advocacy activities have focused on cancer survivorship. In contrast, few former PTSD patients refer to themselves as PTSD survivors. The PTSD community would benefit greatly from PTSD survivorship advocates. Most cancer patients, researchers, and clinicians have a shared goal of hoping for a cure for cancer. In contrast, there has been little emphasis on curing PTSD or treating it into remission. This is despite the fact that the potential for PTSD to be treated into remission or cured is better than many types of cancer. In summary, the similarities and differences between cancer and PTSD may help guide future clinical and research approaches to PTSD in service members and veterans.