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8 Symptoms of PTSD in Adolescent and Young Adult Cancer Survivors

by Anita FernandesOctober 29, 2019View more posts from Anita Fernandes

Survivors of AYA cancer have been exposed to a traumatic event and the effects of their experience can persist for many years after successful treatment. In many cases, AYAs who survive cancer seem to suffer no long-term emotional and mental effects at first but show signs of PTSD in later years.

Symptoms of PTSD in young adult survivors of childhood cancer 

Studies show that survivors of childhood cancer are four times more likely to develop PTSD. The development of PTSD in young survivors of childhood cancer can be disabling but an early diagnosis and treatment plan can help them overcome it. Some of the most common symptoms of PTSD in young adult survivors of cancer include:

  1. Hyperarousal

Hyperarousal occurs when an individual’s body kicks into high alert even though there is no current risk or danger. Hyperarousal is a primary symptom of PTSD and generally occurs when the person is thinking about the trauma of their experience. Young survivors of cancer may exhibit signs of hyperarousal including sudden outbursts of anger, a sense of shame or even self-destructive behavior such as drinking or drugs. Hyperarousal makes these young adults feel ‘on edge’ which is why they find it difficult to relax and are often irritable.

  1. Easily startled

The stress and anxiety associated with PTSD often results in jumpiness where the individual is easily startled or even frightened. Even something as simple as a phone ringing can cause an immediate and unusually strong response. This is known as the fear-potentiated startle (FPS) and this response can be further exaggerated when the individual is experiencing stress. Young adult cancer survivors suffering from PTSD are likely to have an abnormally overactive startle response and may also find it tougher to calm down even after they realize that they are not in any immediate danger.

  1. Development of phobias

The memories of their experiences with childhood cancer often causes young adults to develop a fear of recurrence. In many cases, this can lead to the development of specific phobias including medical phobias. Certain events such as birthdays or doctors’ appointments can aggravate these fears which manifest as increased signs of stress and anxiety. Treatment options such as cognitive behavioral therapy and the human givens approach can help to alleviate fear and phobias in young cancer survivors.

  1. Hypervigilance

Hypervigilance is a state of increased awareness that is aimed at preventing perceived danger. Hypervigilance is one of the most common symptoms of PTSD in young cancer survivors and it generally presents as a constant scrutiny of their bodies and/or symptoms. Their fear and anxiety can cause them to see every change as a potential link to cancer. Hypervigilance can make it difficult for patients to maintain a healthy perspective which can trigger fear and anxiety. Their fear-based need to constantly be on guard often leads to exhaustion and fatigue and can even impair their ability to function on a day-to-day basis.

  1. Complete avoidance of any reminders of their cancer treatment

Young adult survivors of cancer who are suffering from PTSD may avoid places and other reminders of their experience. Even an advertisement warning about cancer or a magazine article on cancer can evoke a strong negative reaction. These young adults may even go so far as to avoid their follow-up medical visits because they are unable to face the memories of their experience. They are also less likely to talk to others and share their experience.

  1. Severe Anxiety

Adolescents who have survived childhood cancer are likely to show signs of anxiety and other PTSD symptoms. This anxiety can trigger nightmares and flashbacks which forces them to re-experience their trauma through the recollections of events connected with their cancer ordeal. Severe anxiety can also lead to hostility, agitation and social isolation. Cognitive Processing Therapy (CPT) can help these young adults understand the root cause of their anxiety so that they can learn to let go of their fear and move on.

  1. Inability to concentrate

Adolescents who have survived cancer often try to repress the effects of cancer on their mental health. Repression is never healthy and it does not help to overcome PTSD- in fact, it can aggravate it. Students suffering from PTSD after surviving cancer may find it difficult to focus and concentrate for even short periods which can severely affects their grades. Prolonged Exposure Therapy can help these young adults face the things they have been avoiding. This will help to lower their stress levels and increase their ability to concentrate.

  1. Sleep Problems

Sleep problems are a common sign of PTSD in young cancer survivors. The stress and anxiety of their experience can lead to difficulties sleeping including difficulty falling asleep or staying asleep. These kids are unable to sleep through the night and instead sleep for just 2-3 hours at a time. They will stop following a regular sleep schedule and instead opt to stay up late playing games or watching movies.

It is important to recognize the early symptoms of PTSD in young adult survivors of childhood cancer. This will help address any mental health issues early on to ensure they can lead happy and healthy lives.


Stuber, Margaret L et al. “Prevalence and predictors of posttraumatic stress disorder in adult survivors of childhood cancer.” Pediatrics vol. 125,5 (2010): e1124-34. doi:10.1542/peds.2009-2308

Cordova, Matthew J et al. “Post-traumatic stress disorder and cancer.” The lancet. Psychiatry vol. 4,4 (2017): 330-338. doi:10.1016/S2215-0366(17)30014-7

Salsman, John M et al. “Posttraumatic growth and PTSD symptomatology among colorectal cancer survivors: a 3-month longitudinal examination of cognitive processing.” Psycho-oncology vol. 18,1 (2009): 30-41. doi:10.1002/pon.1367

Maher, Michael J, et al. “Sleep Disturbances in Patients with Post-Traumatic Stress Disorder.” CNS Drugs, vol. 20, 7, (2006): 567–590. doi:10.2165/00023210-200620070-00003.

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