Researchers have called for routine screening for psychological distress among cancer patients, with fears post-traumatic stress disorder (PTSD) may be going undiagnosed.
A Malaysian longitudinal study of nearly 500 patients published in journal CANCER found 22 per cent had partial or full PTSD six months after diagnosis.
One third were still living with PTSD at four years.
The study also found that, compared with patients with other cancer types, those with breast cancer were 3.7 times less likely to develop PTSD at six months but not at four years.
The findings highlight the need for early identification, careful monitoring and treatment of PTSD in cancer survivors, the researchers say.
They did however note that the results may not apply to non-Asian populations.
"Cross-national research also is needed to confirm whether there are differences between Asian and Western patients with cancer in this regard," the authors wrote.
Although PTSD is primarily known to develop in individuals following a traumatic event such as a serious accident, natural disaster or war, it can also occur in cancer patients.
"Many cancer patients believe they need to adopt a 'warrior mentality' and remain positive and optimistic from diagnosis through treatment to stand a better chance of beating their cancer," said Dr Caryn Mei Hsien Chan at the National University of Malaysia.
"To these patients, seeking help for the emotional issues they face is akin to admitting weakness."
Health psychologist Professor Suzanne Chambers - Director of the Menzies Health Institute Queensland says there are PTSD-like symptoms that can be more common, like intrusive thinking and avoidance but having these does not mean the person has PTSD.
However she says the psychological impact of cancer is a "big issue" and there is a need for routine distress screening and a greater awareness of the psychological burden a cancer diagnosis can have on a patient.
"Certainly cancer is a major life stress that for most people is followed by understandable heightened distress. Anxiety and depression, along with fears about the future and concerns for family are common early on but over time most people find these resolve," Prof Chambers said.
If people find their distress overwhelming or persistent it's important they ask for support, Prof Chambers said.
People can contact the Cancer Council on 13 11 30 for help finding support.
