PTSD in Melanoma

[Anonymous]

I was intrigued by this recent article indicating a high degree of PTSD in patients with cancer:
https://www.oncologynurseadvisor.com/general-oncology/incidence-of-ptsd-among-patients-with-cancer/article/736301/2/

Have you seen signs of PSTD in your patients with melanoma? How can we help these patients?

[Anonymous]

Hi Lisa,

Thanks for bringing this up – it is a great question. I believe some melanoma patients have PTSD. It would have been interesting if this article reported the incidence of PTSD by type of cancer.

I see many newly diagnosed melanoma patients VERY worried that every skin lesion is a melanoma – understandably. It is common for us to evaluate a melanoma patient urgently for a new worrisome skin lesion only to find it is a seborrheic keratosis (which makes sense, these are often large, asymmetric, multicolored ugly skin lesions, all the hallmarks of melanoma). This also means they are noticing their skin which is so important.

The melanoma population is often made up of a large number of young people which also likely contributes to PTSD. This group has so much at stake in their future years; many of them have young families and are trying to wrap their heads around a melanoma diagnosis while wondering if they will see their children go to kindergarten. I also see many patients concerned that sun exposure will cause a recurrence. This is not the case; it may contribute to other skin cancers developing, but it will not contribute to a known melanoma recurring. Lastly, some of the PTSD/anxiety may be from guilt if a person had extensive sun exposure, used tanning beds or never used sunscreen.

So… many reasons to explain why melanoma patients could have PTSD, but more importantly, how can we help them? Obviously, social work is critical and support groups can be very helpful (if separated by advanced melanoma vs early stage melanoma). Aim at Melanoma Foundation has a listing of patient and caregiver support groups by state. Impact Melanoma runs a program called “Billy’s Buddies” which pairs newly diagnosed patients with someone who has a similar stage melanoma or been through the same treatment. Our institution has a “Pt to Pt” program that works this same way. Often, this is invaluable to the new melanoma patient as it gives them hope when they see someone 5 years out from the diagnosis living life fully or carrying on their life through treatment.

Recognizing when a patient is not coping well and getting them support is very important. Nurses are often on the front lines and are in a key position to make an impact here!

Alternative therapies/medicine may also help with PTSD. I am not well informed on this topic, but I think others on this panel are so let us know what you think.

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