Cancer has an impact, not only on the survivor, also family and friends, neighbors, and coworkers. While there is increased awareness among healthcare providers of the post treatment needs of survivors, cultural and social attitudes are slower to change. Family and friends of survivors are often anxious, when treatment ends, to have everything “get back to normal” by encouraging loved ones to “put it all behind them.” In a culture in which the goal is to “win the fight” and “beat cancer” there may be little appreciation for the other aspects of survivorship that may include long-term disability or late effects of treatment.

During the course of treatment and after, survivors’ relationships with friends and family may be stressed and the life course and work of the survivor may be fundamentally changed. Emotional issues, including depression and issues with relationships may affect a survivor’s quality of life after cancer. Practical issues such as lack of funds due to not working or working less, debt concerns and the loss or reduction in health insurance may contribute to poor outcomes and reduced access to care, thus putting survivors at higher risk for illness, disability and death.