For decades, cancer care was centered on one urgent goal: survival. Today, advances in early detection and treatment mean more people are living longer after diagnosis, bringing another question to the forefront: What does it take not only to survive cancer, but to live well through and beyond it?

For the first time, the five-year relative survival rate for all cancers combined in the United States has reached 70 percent, according to the American Cancer Society. About 18.6 million Americans are living with a history of cancer, and that population is expected to exceed 22 million by 2035. As more people live longer following diagnosis, survivorship has become an increasingly important part of cancer care.

Four North Texas professionals working in oncology, psychosocial support, cancer-specific exercise and health coaching see survivorship from different vantage points. Together, they describe a more complete model of care that begins at diagnosis and addresses physical health, emotional well-being, daily function and quality of life.

Survivorship Begins at Diagnosis

Syed Kazmi, M.D., a medical oncologist at UT Southwestern Medical Center’s Harold C. Simmons Comprehensive Cancer Center specializing in gastrointestinal cancers, says survivorship is about “living well after a cancer diagnosis.”

The 70 percent five-year survival milestone represents tremendous progress in cancer detection and treatment, but it also creates a growing responsibility to address what happens during the years people are living with and beyond cancer.

For Kazmi, that means widening the lens beyond whether treatment has worked. Survivorship begins at diagnosis and continues throughout the cancer journey, including for people still receiving treatment or living with cancer as a chronic condition.

“Cancer survivorship is about helping people live better, even if with cancer, not just live longer,” he says.

That distinction matters. A successful cancer outcome may still leave someone managing fatigue, physical changes, emotional stress or uncertainty while trying to return to work, resume family responsibilities or regain confidence in daily life.

Kazmi believes oncology has an opportunity to make that broader definition part of routine care. He points to exercise and healthy eating as practical tools that can help restore strength, energy, confidence and quality of life. He would also like survivorship programs that include nutrition, exercise and mental health support to become a standard part of cancer care rather than resources patients must find on their own.

The shift does not lessen the importance of treating disease. It expands the measure of good cancer care from how long a person lives to how well that person can live.

The Emotional Journey Continues

Chad Black, development director and incoming CEO of Cancer Support Community North Texas, sees another gap when treatment ends: the assumption that the emotional journey should end, too.

Being declared cancer-free, Black says, does not necessarily mean someone feels free from cancer. Regular appointments may decrease while fear of recurrence, lingering side effects, uncertainty and questions about identity remain.

“Survivorship is not simply about beating cancer,” Black says. “It is about living through cancer.”

He recalls a participant with Stage IV pancreatic cancer, whom he calls Tim, who had helped secure items for an upcoming fundraiser. Tim told Black that he did not expect to be alive when the event occurred. The conversation reshaped Black’s understanding of good survivorship care.

Sometimes care means being willing to remain present with grief, uncertainty and mortality without trying to fix what cannot be fixed. It can mean protecting dignity, creating opportunities for meaning and allowing people to be heard.

Support can also look remarkably ordinary. At a Cancer Support Community social gathering, one woman told Black she valued being somewhere she could simply be herself rather than “the cancer patient.” Participants shared food, conversation and laughter, often without talking about cancer at all.

That kind of connection, Black says, can restore a sense of normalcy and belonging. Emotional support is not an extra reserved for crisis. It is part of whole-person cancer care.

Rebuilding the Body and Confidence

Deb Brackenridge, LIVESTRONG at the YMCA coordinator for the YMCA of Metropolitan Dallas, sees survivorship through movement and physical recovery.

The 12-week LIVESTRONG at the YMCA program is designed specifically for adult cancer survivors. Certified personal trainers with specialized cancer-survivor training begin with a functional assessment and adapt exercise around surgeries, medications, physical limitations and medical restrictions.

Brackenridge has watched a participant who initially needed to remain seated during class progress to standing and using a light dumbbell. Others who once struggled with fatigue have built enough endurance to attend class and still have energy to garden or grocery shop later that day.

“These moments are beyond exciting,” she says.

For survivors, such gains can represent independence, confidence and renewed participation in everyday life. The group setting also connects participants with people who understand the cancer experience.

The goal is not simply fitness. It is helping people safely rebuild strength, endurance, confidence and overall well-being.

Creating a New Normal

Kate Cruickshank, MPH, BSN, RN, NC-BC, a board-certified health and wellness coach and registered nurse specializing in cancer support, says survivorship has changed the way she thinks about “normal.”

Her earlier view centered on helping people get back to normal after treatment. Now, she says, the more realistic goal is helping people create a healthy and meaningful new normal.

“Being cancer free and being well are not necessarily the same thing,” Cruickshank says.

Survivors may still face fatigue, nutrition and sleep concerns, fear of recurrence, relationship changes, returning to work, loss of confidence or difficulty trusting their bodies. Oncology teams may provide excellent treatment and medical advice, but Cruickshank sees a gap between receiving that advice and integrating it into daily life.

Health and wellness coaching can help translate recommendations into manageable actions. She encourages people to focus on choices within their control, including how they nourish themselves, move, manage stress, communicate their needs and direct their energy.

Intentional breathing and grounding practices can also help people feel more present and capable. Cruickshank stresses that these tools are not about positive thinking controlling cancer. Their value is in restoring agency after an experience that can make life feel profoundly out of control.

She believes survivorship care should routinely assess physical and emotional well-being, address late and long-term effects and connect people with appropriate resources instead of leaving them to assemble support on their own.

A More Complete Definition of Recovery

Together, the four perspectives show why survivorship is becoming an essential part of cancer care.

Medical treatment remains the foundation. But living well can also involve rebuilding strength, restoring sleep, nourishing the body, managing stress, processing fear and grief, reconnecting socially and finding purpose in a life that may not look exactly as it did before diagnosis.

No single provider can address every need. The opportunity is to build stronger connections among oncologists, primary care providers, mental health professionals, rehabilitation and fitness programs, dietitians, coaches and community organizations so patients know where to turn.

For survivors, living well after cancer may not mean returning to who they were before diagnosis. It may mean understanding what their body needs now, deciding what matters most, accepting support and discovering new ways to feel strong, connected and engaged in life.

Survivorship is not merely what happens after cancer treatment. It is part of cancer care itself.

NORTH TEXAS CANCER SURVIVORSHIP RESOURCES

UT Southwestern Harold C. Simmons Comprehensive Cancer Center
Offers cancer treatment, rehabilitation, psycho-oncology and survivorship-related services in Dallas and through Moncrief Cancer Institute in Fort Worth.
HOPE Line: 214-645-4673
Website: UTSouthwestern.edu/cancer

Cancer Support Community North Texas
Provides free support groups, individual counseling, educational programs, healthy lifestyle activities, social programs and resource navigation for people affected by cancer and their loved ones. In-person and virtual programs are available.
Phone: 972-630-6131
Website: CancerSupportTexas.org

LIVESTRONG at the YMCA, YMCA of Metropolitan Dallas
A free 12-week small-group program for adult cancer survivors focusing on strength, cardiovascular conditioning, balance, flexibility and connection. Medical clearance is required; YMCA membership is not.
Contact: Deb Brackenridge
Phone: 214-212-7484
Email: [email protected]
Website: YMCADallas.org/LIVESTRONG-YMCA

Kate Cruickshank, MPH, BSN, RN, NC-BC, Thrive Beyond Coaching
Board-certified nurse coach and registered nurse providing health and wellness coaching for people navigating cancer, treatment, recovery and survivorship.
Website: NurseCoachKate.com