Improving Health and Quality of Life After Cancer

While cancer survivors are living longer after their diagnosis, at least one-third of the more than 15 million survivors in the United States face physical, mental, social, job, or financial problems related to their cancer experience. These psychosocial and physical concerns may affect family members, friends, and others who provide comfort and care to survivors.

Through data, translation, and partnership, CDC works to address these and other challenges faced by cancer survivors and improve survivors’ health and quality of life.

Physical Health Concerns

Some behaviors, experiences, or other factors increase some survivors’ risk of having their first cancer come back, getting a new cancer, and having other health problems. Factors that increase such risks for cancer survivors include—

• The side effects of treatment.
• Genetic factors, such as those that can cause hereditary breast and ovarian cancer and Lynch syndrome.
• Unhealthy behaviors like smoking, obesity, and lack of physical activity.
• Other risk factors that contributed to the first cancer.

What Can Be Done?

After treatment ends, cancer survivors should get follow-up care—routine checkups and other cancer screenings. Follow-up care can help find new or returning cancers early and look for side effects of cancer treatment.

Survivors also can lower their risk of getting a new or second cancer by healthy choices like—

• Avoiding tobacco.
• Limiting alcohol use.
• Avoiding too much exposure to ultraviolet rays from the sun and tanning beds.
• Eating a diet rich in fruits and vegetables.
• Keeping a healthy weight.
• Being physically active.

Mental Health Concerns

Cancer survivors may experience mental health concerns that affect their emotions, behavior, memory, and ability to concentrate. For example, cancer survivors may feel emotional distress like depression or anxiety about their cancer returning. Recent research found that 10% of cancer survivors have mental health concerns, compared with only 6% of adults without a history of cancer.¹ Cancer survivors who have other chronic illnesses are more likely to have mental health problems and poorer quality of life.

Fewer than one-third of survivors who have mental health concerns talk to their doctor about them, and many survivors don’t use services like professional counseling or support groups.

What Can Be Done?

• Survivors should talk to their health care providers about their mental health before, during, and after cancer treatment.
• Survivors should talk to their health care providers about mental health screening to check for and monitor changes in anxiety, depression, and other mental health concerns.
• Psychologists, social workers, and patient navigators can help survivors find appropriate and affordable mental health and social support services in both hospital and community settings.
• Physical activity has been linked to lower rates of depression among cancer survivors.²

Concerns About Work and Money

Cancer survivors may struggle to pay for medical care and are more likely to declare bankruptcy than people without a cancer history. They also face work-related concerns because of their cancer experience. While many survivors return to work, about one-third cannot work at all or have less ability to work due to mental and physical health problems.^{3 4}

What Can Be Done?

To help address money problems and make the return to work easier, survivors can learn more about—

• Changes in health care in the United States and options for affordable health insurance.
• Ways in which their employer may be able to help, like a non-traditional work schedule, employee assistance programs, and options for employees to donate unused paid time off to sick coworkers.
• The Family and Medical Leave Act and short-term disability leave.

References

¹Weaver KE, Forsythe LP, Reeve BB, Alfano CM, Rodriguez JL, Sabatino SA, Hawkins NA, Rowland JH. Mental and physical health-related quality of life among U.S. cancer survivors: population estimates from the 2010 National Health Interview Survey. Cancer Epidemiology, Biomarkers and Prevention 2012;21(11):2108–2117.

²Zhao G, Okoro CA, Li J, White A, Dhingra S, Li C. Current depression among adult cancer survivors: findings from the 2010 Behavioral Risk Factor Surveillance System. Cancer Epidemiology 2014;38(6):757–764.

³Ekwueme DU, Yabroff KR, Guy GP Jr, Banegas MP, de Moor JS, Li C, Han X, Zheng Z, Soni A, Davidoff A, Rechis R, Virgo KS; Centers for Disease Control and Prevention (CDC). Medical costs and productivity losses of cancer survivors—United States, 2008–2011. MMWR 2014;63(23):505–510.

⁴Dowling EC, Chawla N, Forsythe LP, de Moor J, McNeel T, Rozjabek HM, Ekwueme DU, Yabroff KR. Lost productivity and burden of illness in cancer survivors with and without other chronic conditions. Cancer 2013;119(18):3393–3401.