Cancer Survivors Face Lingering Mental Health Crisis as Survivorship Rates Climb
核心洞察
More than 18 million cancer survivors live in the U.S. as of 2025, with projections reaching 22 million by 2035, yet mental health support remains critically inadequate.
A national survey by Cancer Nation (搜索) found approximately one-third of post-treatment survivors report anxiety about recurrence and loss of identity, while only 1 in 5 have seen a mental health professional.
Oncology experts acknowledge the field has historically neglected psychological care, with UCLA's Patricia Ganz noting clinicians are "not really schooled in the antidepressants."
The cancer diagnosis came as a shock to Morgan Newman in 2015. At just 24 years old, working as a dental assistant in Des Moines, Iowa, while studying to become a social worker, an abnormal Pap smear led to a follow-up examination — and ultimately a diagnosis of cervical cancer (搜索). She had just moved into her own apartment for the first time.
Newman's story is increasingly common. More than 18 million cancer survivors were living in the United States in 2025, and the National Cancer Institute projects that number will grow to 22 million by 2035. Yet long after completing treatment, many survivors face lingering mental health challenges that go largely unaddressed by the healthcare system.
Newman underwent six weeks of radiation and chemotherapy. Her scans after treatment were clear — until the six-month mark, when doctors found suspicious nodules in her lungs. She endured additional chemotherapy with more severe side effects. The physical toll was exhausting, but the psychological burden proved equally devastating.
"My friends were getting married, they were having children, you know, progressing in their lives and their careers, and I just felt stuck," Newman said.
The Financial and Emotional Toll of Survivorship
Before her diagnosis, Newman had attended therapy for anxiety and depression. After she became ill, she had to stop — therapy was too expensive alongside mounting medical bills, and between doctor appointments, college courses, and her full-time job, there was simply no time.
By 2017, with a new job offering better health benefits, Newman returned to therapy. She worried that every ache and pain signaled the cancer's return. The radiation treatment had damaged her reproductive system, leaving her unable to have children — making time spent with friends who had kids emotionally difficult at times.
"The fear of the unknown really takes over and can physically impact your body, as well as your mind," Newman said. The question kept circling: "What if the cancer is back?"
Now, nearly a decade later, Newman remains cancer-free. Cancer prevention has become her passion — she started a new job in December as the Iowa grassroots manager for the lobbying arm of the American Cancer Society and has served on the boards of other cancer organizations in Iowa. Yet she continues therapy to manage lingering anxiety about recurrence and the lasting effects of treatment, including infertility.
The Scope of the Problem
Studies confirm that cancer survivors experience anxiety and depression that can persist for years after treatment ends. The advocacy group Cancer Nation (搜索) conducted a national survey of patients who had completed treatment, finding that approximately one-third reported anxiety about their cancer potentially returning, as well as problems with not feeling like their "old self." Critically, only 1 in 5 surveyed survivors reported having seen a mental health professional.
"Part of it is, I don't think we have enough. I think some people need mental health professionals who really understand cancer," said Shelley Fuld Nasso, CEO of Cancer Nation (搜索).
Iowa: A Microcosm of the Access Crisis
Iowa exemplifies the challenges at the intersection of cancer burden and mental health access. According to the Iowa Cancer Registry, the state has the second-highest rate of new cancer diagnoses in the nation. The number of Iowans living five years after their diagnosis has increased approximately 0.4% each year since 2000. University of Iowa scientists who run the registry are now conducting a two-year, state-funded project to investigate the underlying causes.
Iowa is also largely rural. Some of the counties with the highest cancer rates also have the fewest mental health workers. Newman cycled through several therapists before securing an appointment with Julie Larson, a Des Moines-based therapist who specializes in working with cancer survivors.
"I just felt like I needed something more specific to what I was going through," Newman said.
In Larson's practice, it is common for clients to begin therapy months or even a year after finishing treatment — when they realize they are not feeling how they expected to feel.
"Physically, people's bodies have changed," Larson said. "And they are reconciling loss and grief. And those experiences are a little bit more silent, a little more invisible, and friends and family don't often fully understand or grasp that."
Larson noted that cancer survivors often seek her out specifically because she understands the disease and its treatments. "I'm not a doctor, but I've done this a long time. So I know what happens when people have Adriamycin. I know the treatment protocol for carboplatin," she said, citing chemotherapy drugs.
Oncology's Blind Spot
When it comes to treating cancer, the field of oncology has historically neglected mental health, according to Patricia Ganz, an oncologist and professor at the UCLA School of Public Health who has spent decades researching cancer survivors and their lingering challenges.
"We know how to give pills. We know how to give pain medicine, sleep medicines. But we're not really schooled in the antidepressants," Ganz said.
Ganz acknowledged increasing awareness about the need to screen for psychological distress in cancer patients and to provide mental health services for both patients and survivors. However, expert-recommended screenings and referrals do not always occur to the extent they should.
"If you screen, that means you have to be able to provide services. That's not always available if you don't have access to a mental health professional. So that has not been done as rigorously as it should be in general practice," she said.
Institutional Responses
Some cancer centers are beginning to address the gap. The MercyOne Richard Deming Cancer Center in Des Moines has started offering services such as counseling, music therapy, and mindfulness sessions to reduce stress for those both in and out of treatment.
"You get cared for intensely when you're getting treated for cancer," said Richard Deming, the medical director at the clinic named for him. By contrast, he said, when people complete treatment, the care typically shifts: "It's almost like, 'You should feel fortunate that you're cancer-free and just get on with your life.'"
To treat cancer comprehensively, Deming argued, doctors need to pay attention to far more than just physical symptoms — a shift in clinical practice is required.
"Every step along the way, whether it's through diagnosis or treatment or follow-up, we have to ask, 'What are the issues you're experiencing?'" Deming said. "Not just: 'Do you have cancer? Did we get rid of the cancer?'"