THURSDAY, Sept. 4 (Health.com) — The special terrors of the Iraq war have shone new light on post-traumatic stress disorder (PTSD) as it is suffered by U.S. soldiers. But medical patients undergoing arduous procedures and treatments can experience PTSD symptoms too, according to a California pain expert.
At the PainWeek conference in Las Vegas this week, Thomas Strouse, MD, professor of clinical psychiatry at UCLA, stressed the importance of minimizing pain, fear, and other trauma that accompany cancer treatment, in particular.
Cancer patients, Dr. Strouse says, may feel they are under terrifying physical threat, may feel a loss of control, and may experience prolonged pain or other discomfort such as profound nausea, laying the groundwork for PTSD.
According to Dr. Strouse, PTSD symptoms have been most clearly described in adolescent patients who relive the trauma of childhood cancer treatment when they have to go in for tests and checkups. But, he says, “It can happen in adults who have gone through arduous medical experiences as well. One of the big unanswered questions in PTSD research is: Why do some people exposed to a trauma get PTSD and others don’t?”
Complex genetic and social factors probably spare some patients and burden others, he says. But the lesson for patients going into a traumatic medical experience, such as cancer surgery and chemotherapy, is that all efforts should be made to anticipate and reduce discomfort and the sense of helplessness that these procedures can induce.
“Talk about the procedures,” Dr. Strouse advises patients who deal with doctors. “Talk about both behavioral and medication preparation that will help you get ready for the procedure.”
Although pain is only one aspect of the trauma that can spark PTSD, it is especially relevant in the context of medical treatment, and physicians now recognize that pain control is vitally important in the recovery process.
If you’re slated for an operation (or helping a child through the experience), “Talk about what postoperative pain control will be like,” Dr. Strouse says. “What will be done to reduce my pain? Who can I get in touch with if I don’t like my pain control?”
The goal is not only to reduce the pain of a medical procedure, but to avoid the pain of reliving a bad experience. That message is getting out to doctors, Dr. Strouse says, even if they don’t frame it in terms of PTSD. “I’m not sure it’s discussed in PTSD language, but it’s well understood now that it’s better to reduce the trauma of procedures at every level, right down to treatments on babies.”
By Scott Mowbray