PTSD and lymphoma: Two very different psychological trajectories following a common diagnosis.

Abstract

195 Background: Long-term chronic lymphoma survivors report lower quality of life compared to those who are cured of lymphoma, despite an equal prevalence of PTSD symptoms in both groups. Posttraumatic Growth (PTG), or positive psychological change following a traumatic event, has been associated with greater acceptance of the disease and greater quality of life, particularly because PTG has been shown to diminish the negative effects of PTSD symptoms. Methods: Semi-structured, in-person qualitative interviews were conducted among a convenience sample of lymphoma survivors. Participants answered questions about their emotional reactions after diagnosis, during treatment, and symptoms of PTSD and positive changes—if any—that developed during the cancer experience. Interviews were audiotaped, transcribed, and analyzed using Grounded Theory methodology. Results: 77 lymphoma survivors - 75% chronic lymphoma, 25% curable lymphoma completed interviews. Themes included 1) disease: perception of health; 2) support system: physician support, social support, and healthcare system support; 3) internal processing: acquiring knowledge, and coping mechanisms; 4) fear: stigma of cancer; 5) growth: relationship with others, and appreciation of life; and 5) acceptance: preparation, and death & dying. Most participants, regardless of chronic or curable diagnoses, reported distress during diagnosis and treatment within the categories: perception of health, healthcare system support, social support, and acquiring knowledge. Chronic lymphoma participants reported less fear and subsequently less growth than their curable counterparts. Participants further viewed their cancer as carrying a different stigma, which then resulted in these blunted reactions. Conclusions: Chronic lymphoma patients do not follow the same psychological trajectory as their curable counterparts with regards to long-term adjustment. They, instead, emulate patients with other chronic disease. The blunted psychological experience of both PTSD symptoms and PTG could potentially explain the lower reports of quality of life in the long term cancer survivor with indolent disease.