Interventions for the treatment of cancer‐related traumatic stress symptoms: A systematic review of the literature

Abstract

Objective: Cancer has been reported to trigger symptoms of post-traumatic stress disorder (PTSD) in a substantial proportion of individuals. Despite the significant burden associated with these symptoms, there are as yet no therapeutic guidelines. This systematic review aims to evaluate the effectiveness of interventions for cancerrelated post-traumatic stress in order to provide an evidence base for developing appropriate clinical practice. Methods: Databases searched until April 2018 included Psych INFO, EMBASE, Medline, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL). No restrictions to study design were applied. Participants aged 18 years or older who received their cancer diagnosis in adulthood and had symptoms of cancer-related PTSD were included. Because of significant clinical heterogeneity, a meta-analysis was not performed. Results: Of 508 unique titles, eight studies met study inclusion criteria: five randomised controlled trials (RCTs), one before-and-after study, one case series, and one case study. Interventions were predominately psychological and were administered to patients with a range of cancer types. Eye movement desensitisation and reprocessing and cognitive behavioural therapy-based interventions were associated with reduced symptomatology; however, overall the methodological quality of studies had limitations. Conclusions: At present, there is only weak evidence available for the effectiveness of psychological interventions in reducing symptoms of cancer-related PTSD. The majority of interventions were administered to all cancer patients regardless of whether they showed pretreatment levels of post-traumatic stress. Future studies would be better targeted towards patients with a diagnosis of cancer and who have significant levels of cancer-related post-traumatic symptoms. Higher quality trials are also needed before treatment recommendations can be made.

EMDR in Cancer Patients: A Systematic Review

“…However, the expert recommendation regarding the treatment of cancer-related PTSD is that it should be approached with caution and be informed by existing evidence-based approaches for traumatic stress (Kangas, 2013;Kangas et al, 2013;Cordova et al, 2017). Although stressing the limits due to the low number of studies included, a recent review has provided evidence supporting the use of trauma-focused interventions (i.e., EMDR and CBT) in treating cancer-related PTSD symptoms (Dimitrov et al, 2019).…”

“…Preliminary evidences suggest that EMDR can be a useful treatment for both depression (Carletto et al, 2017;Malandrone et al, 2019) and anxiety disorders (Faretta and Dal Farra, 2019;Yunitri et al, 2020). Finally, a previous review has shown that trauma-focused interventions are effective in reducing PTSD symptoms in patients with cancer (Dimitrov et al, 2019). Therefore, the aim of the present systematic review is to summarize the current literature on the effect of EMDR on cancer-related psychological distress.…”

Post-traumatic Stress Symptoms and Serotonin Transporter (5-HTTLPR) Polymorphism in Breast Cancer Patients

“…More attention and research to key environmental and biological risk factors for PTSD (e.g., childhood adversity, possible biological predisposing factors, including stress-driven activation of biological, and endocrine pathways) that are influential in the maintenance of PTSD and worse patient outcomes (45). With respect to this, further studies are needed to better clarify the role of the serotonin system in the development of PTSS in order to identify women who may be at heightened risk of PTSD amongst breast cancer patients and to properly integrate psychopharmacological and psychological approaches to lessen the negative impact of this chronic mental health condition (46,47).…”

Therapist‐led interventions for the treatment of traumatic stress symptoms in cancer survivors: A systematic literature review

“…A recent systematic literature review by Dimitrov and colleagues 17 aimed to evaluate the effectiveness of interventions for cancer‐related post‐traumatic stress; however, the authors excluded papers where participants had not been clearly screened for PTSD or used validated PTSD measures that had subscales that assessed for other symptoms such as depression and overall psychological distress. This inevitably limited the focus of their review (only eight studies were found that matched the review's inclusion criteria).…”

“… 19 , 1 2 Indeed Mundy and Baum 20 stated that PTSD might not be the right diagnosis to represent the emotional and social distress which cancer patients experience; although the PTSD diagnosis may capture many of the traumatic stress symptoms experienced by cancer patients, it may not incorporate the multidimensionality of lasting responses that are typical of the cancer experience 21 ,. 22 Furthermore, Dimitrov and colleagues' work 17 is limited to literature published up to April 2018, and therefore, our review provides with an overview of the most recent literature in the field.…”