Psychological and physical challenges associated with a cancer diagnosis and treatment may be exacerbated in individuals with a history of trauma exposure (TE). This may affect many people with cancer, as 75% of Australians have been exposed to at least one traumatic event during their lifetime. Previous findings indicate the broad impact of TE on cancer care, spanning diagnosis, treatment, survivorship outcomes (physical and psychological), quality of life, and care/service delivery. A history of TE has been associated with elevated distress, anxiety, depression, and poorer adjustment to cancer survivorship.
Despite growing awareness of the impact of TE in cancer care, trauma-informed care has not been discussed in the context of brain cancer. People with brain cancer and their families often experience high levels of distress and existential concerns due to poor prognosis associated with the disease. Brain cancer symptoms can result in pervasive and multifaceted disabilities often nuanced and unique. In particular, neurological symptoms, cognitive impairment, and personality and behavioural changes can affect individuals' sense of self, relationships, and sense of safety, leading to feelings of lost control and reduced agency. This can create an additional emotional and psychosocial burden for those affected, while access to coordinated and timely support remains limited.
A trauma-informed care framework may be useful for recognising the various forms of trauma experienced in the context of brain cancer by patients, caregivers, and healthcare professionals. To date, no trauma-informed model of cancer care has been evaluated or implemented. However, existing models from health domains outside oncology highlight several core principles of trauma-informed care, including safety, connection and peer support, empowerment and choice, trustworthiness and transparency, and collaboration and mutuality. Trauma-informed care holds strong potential to improve both clinical and person-centred outcomes in brain cancer care.