Parents of children with cancer commonly develop symptoms of post-traumatic stress that can be significant for years afterward as their surviving children grow up, according to articles published in the Journal of Clinical Oncology and the Journal of Family Psychology.

“We have found, time and again, that we need to approach and treat these types of traumatic stress from a family perspective,” said study leader Anne E. Kazak, PhD, director of Psychology and co-director of the Center for Pediatric Traumatic Stress at Children’s Hospital.

In the first phase of the study, American researchers evaluated and followed parents of children undergoing treatment for cancer. Among 119 mothers and 52 fathers, all but one parent had some symptoms of post-traumatic stress.

The second study evaluated 98 couples who were parents of an adolescent survivor of childhood cancer. The adolescents had completed treatment an average of five years before the study. Although parents’ post-traumatic stress symptoms were less common than in parents during their children’s treatment, in a majority of families studied, at least one of the parents had signs of moderate to severe post-traumatic stress.

In an editorial accompanying the Journal of Clinical Oncology study, Sharon Manne of the Fox Chase Cancer Center in Philadelphia, refers to parents of children with cancer as the “invisible patients.” Even when cancer treatment achieves a cure, she says, “Fear of recurrence is a universal, never-ending worry for parents.”

She noted that traditional measures of psychological distress, which focus on anxiety and depression, “do not capture the full picture,” and calls for broadening evaluations of the parents to include assessing traumatic stress responses.

In a previous study, the same research team found that 20 percent of families of adolescent survivors of childhood cancer had at least one parent with current post-traumatic stress disorder.