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Urging the person to be ‘grateful to be alive’ may compound a sense of isolation and being poorly understood. 345 Spouse relationships that were unsatisfactory before the illness may not survive as the survivor makes a new start in life. Anecdotal evidence suggests that this may particularly apply in cases when the person has survived as a result of a bone marrow donation. Concerns about recurrence Survivors are vulnerable to fears of recurrence, and must confront this each time they feel unwell or present for follow-up testing or screening.

7). The bulk of the research to date has focused on patients with breast cancer. 176-180 Many who do not meet the strict criteria for PTSD still report a high level of intrusive symptoms such as recurrent thoughts about the cancer diagnosis, or aspects of treatment. 181 A number of risk factors for PTSD have been identified in cancer patient. 178,180 Among patients with colorectal cancer, the reported rate of PTSD is twice as high in women as in men. 183 Traumatic symptomatology may persist long-term.

127 Sexual symptoms are also commonly reported by patients who have undergone bone marrow transplantation. 2 the negotiation of new relationships post cancer treatment poses a complex series of concerns for many patients. Clinical practice guidelines for the psychosocial care of adults with cancer 35 Specific emotional issues related to survival The nature of the emotional concerns of those who have survived cancer is an emerging area of research, and there are limited data about issues specific to different clinical groups.

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