The ghost of the war within

Episode 6 – What about now? Collective COVID-19 trauma and cancer

Characterized by uncertainty, rapidly changing guidelines, amplified individual differences in both patients and health care providers in risk aversion and tolerance for uncertainty; the COVID-19 pandemic has put an unimaginable burden on cancer survivors. Moreover, the outbreak of the COVID-19 pandemic, has been referred to by many with Nicholas Taleb’s term, as the “black swan” for mental health care and a possible turning point for the delivery of psychological services (Wind et al., 2020). The number of studies, articles, publications, interviews, vlog entries, webinars tackling the impact of the pandemic on mental health is increasing in hyper speed, as the extent of health-related worry during the pandemic reached an all-time high in the majority of population groups, indifferent of their vulnerability. It has also made us more trauma-conscious and open to new solutions and connections.

Episode 3 – Receiving the news

Clinical studies have reported many patients experiencing peritraumatic distress or dissociation during the medical conversation in which a cancer diagnosis is communicated. The manner of doctor - patient communication is one of the few factors that can be adapted, and even if it likely cannot prevent the trauma, it might modulate the development of subsequent trauma disorders. The importance of being sensitive and respectful toward patients while communicating the cancer diagnosis and adapting the manner of conversation to their needs should be included into institutional training courses on communication skills.

Episode 2 – Screening for risk factors

One of the major clusters of information, which could highly benefit not just all potential and actual patients and cancer survivors, but also experts and primary care professionals in the context of prevention of PTSD development, but also in the process of screening for an already underlying condition is about the risk factors, associated with developing PTSD.  Having evidence-based information regarding which conditions can considerably contribute to the development of PTSD in the oncological journey is important not only because the presence of PTSD can have a direct negative impact on cancer treatment, decreases the quality of life of these patients, but also because of the high comorbidity with other disorders, especially depression can become an issue even a long time after the patient has survived cancer.

Episode 5 – Humor, art and books

Cancer, that’s the suitable first word, though nobody said it right away, not right off; on the other hand, I wouldn’t go so far as to say that the doctors avoided it…. – an extract from Péter Esterházy's Pancreatic Diary, translated by Judith Sollosy. This episode is exploring the role of humor, art and literature in coping with cancer related PTSD

Episode 4 – Treatments

As the number of people diagnosed with cancer increases and cancer survivorship improves, providing for cancer patients' physical and psychological needs becomes increasingly important and cancer‐ related PTSD becomes a more prominent issue. Previously discussed conceptual issues specific to cancer‐related PTSD such as the difficulty in pinpointing to the single specific traumatic event, the ongoing, complex nature of possible stressors, and the overlap between symptoms of PTSD and other adjustment, anxiety and mood disorders common amongst cancer patients lead to a rather difficult path of finding proper treatment. The small number of studies and the wide variation in their methodology is limiting the the strength of conclusions that can be drawn and the possibilities to address a wider audience in investigating the possibilities. This episode is investigating the conclusions of some of the studies already conducted and it is again a call for further studies assessing the effectiveness of treatments for cancer‐related PTSD.