When Terror and War Supersede Cancer: A Case Study of a Ukrainian Cancer Survivor and Application of Trauma-Informed Care.

Abstract

This case study describes the implementation of trauma-informed and culturally informed cancer care, for a 40-year-old Ukrainian female with recurrent follicular lymphoma, displaced to the United States in the Spring of 2022 following the Russian invasion of Ukraine. The patient was referred to the psychosocial oncology service at an NCI-designated Comprehensive Cancer Center for evaluation and treatment of depression and anxiety. Stressors, along with the chronic trauma of fearing for her family's safety and the stress of being displaced from Ukraine, compounded her emotional burden. A modified form of trauma-informed care adapted for use with refugee and immigrant populations was applied, in addition to evidence-based treatments including Acceptance and Commitment Therapy, Cognitive Processing Therapy, and other cognitive behavioral techniques. At the conclusion of therapy, significant improvements were reported across physical function, social engagement, and emotional well-being. This case highlights the importance of flexibility in treatment modalities and the need to consider that the trauma of an ongoing and unpredictable war may require more therapeutic support than the experience of cancer.