Beyond survival: Why cancer survivorship matters

Professor Pernilla Lagergren

This festive period, Three Wise Women from the Faculty of Medicine will be giving us the gift of wisdom.


When cancer treatment ends, a new journey begins—one filled with unique challenges. Professor Pernilla Lagergren, Chair in Surgical Care Sciences at the Department of Surgery and Cancer, explores what life is like after cancer treatment. Drawing on her clinical experience with oesphageal and gastric cancer patients, she shares how her survivorship research is helping to shape better outcomes for patients, their families, and the healthcare system. 

When people think about cancer, they often focus on the illness itself—the diagnosis, the treatments, and the fight to survive. But once the treatment ends, another important challenge begins: what happens after cancer? As a researcher in cancer survivorship, my focus is on understanding what life is like for people who have been treated for cancer, and how we can improve that life for them. 

Here, I’ll explore the significance of cancer survivorship research, the insights we’ve gained, and what drives my commitment to this field. I‘ll also highlight how my work contributes to improving the lives of cancer survivors, supporting their families, and strengthening the healthcare system. 

What is cancer survivorship? 

When a person is diagnosed with cancer, they often face a long and difficult journey. They go through treatment, which can include surgery, chemotherapy, or radiation. But after the treatment ends, the patient’s journey does not simply stop. Life after cancer can bring its own set of challenges. 

Cancer survivorship research focuses on understanding what happens after treatment—both the physical and emotional effects. For example, many cancer survivors experience ongoing fatigue, anxiety, or, for the oesophageal and gastric patients I am focusing my research on, difficulties with eating. Others might face challenges in returning to work or adjusting to their new lifestyle. These issues do not always receive the attention they deserve, even though they affect millions of people worldwide. That’s where my research comes in. 

Why am I passionate about cancer survivorship? 

As a specialist nurse working closely with oesophageal and gastric cancer patients from referral to end of follow up or end of life, I have seen firsthand how cancer affects people’s lives—not just during treatment, but long after. It was during my clinical work that my research interest started. I wanted to know more about the factors that impact patient’s survivorship and what we could do to help patients in their recovery. People might think that once cancer treatment ends, patients are “done” with cancer, but that is rarely the case.  

Cancer research tends to focus heavily on survival rates and medical treatments. While these are incredibly important, we often overlook the fact that many cancer survivors face long-term health issues. These can include physical symptoms like pain or trouble sleeping, or emotional challenges such as depression and anxiety.

“People might think that once cancer treatment ends, patients are “done” with cancer, but that is rarely the case.”

Nowadays, I work full-time as a researcher both in Sweden and in the UK and my contacts with patients do not come daily. Nevertheless, this has led to continued close collaboration and involvement of patients and their next of kin in my research, from idea generation through to publication. This is a collaboration I value extremely, especially since my research is focusing on cancer survivorship. 

What are we learning through survivorship research? 

Through ongoing research, we are learning that cancer survivorship is about much more than just being “cancer-free.” It’s about rebuilding life after cancer, addressing the short- and long-term challenges that survivors face, and ensuring their wellbeing in the years following treatment. In our research we have shed light on the short- and long-term physical and emotional challenges faced by survivors of oesophageal and gastric cancer. These challanges can significantly impact daily life, highlighting the need for better post-treatment care to address these issues. To help manage these concerns, our research aims to develop programs and tools that support recovery after treatment and empower patients to regain control over their health and future. 

A central theme in my work is the importance of personalised survivorship care, which tailors rehabilitation programs and follow-up care to meet the unique physical and psychological needs of each survivor. Ultimately, our research is helping to shape more effective clinical guidelines and interventions that ensure cancer survivors receive the comprehensive care they need for the long-term.  

Why should this matter to the public? 

Survivorship research is not just for the medical community—it is for everyone. If you or someone you love has had cancer, the challenges of survivorship will be real for you, too. Understanding what cancer survivors go through is essential for improving their quality of life. 

For example, if we can help clinicians recognise the long-term effects of cancer treatment, they can provide better care for their patients. If society becomes more aware of the struggles cancer survivors may face, it can lead to more support—whether that is through better workplace accommodations or better insurance coverage for long-term care. 

It also gives us hope that cancer survivorship does not have to mean simply “living through it”—it can mean living well. We can help cancer survivors lead full, healthy, and productive lives, even after they have finished their treatment. 

“Cancer survivorship does not have to mean simply “living through it”—it can mean living well.”

What’s next in survivorship research? 

There’s still so much more to learn. We are continually exploring new ways to improve the care and wellbeing of cancer survivors and to make such new ways personalised and tailored. As we continue this work, it is important to remember that cancer survivorship is a journey, not a destination. Every survivor’s experience is different, but by understanding those experiences better, we can improve the lives of everyone touched by cancer. 

So, to summarise, cancer survivorship is a critical yet often overlooked part of the cancer journey. My research aims to fill this gap, focusing on the physical, emotional, and social challenges faced by oesophageal and gastric cancer survivors after their treatment ends. By better understanding these challenges, we can offer more effective individualised support and care. As one patient said to me when we were talking about recovery – “there is no way back, only a way forward.” Ultimately, my goal is to identify interventions and provide support to help patients on their way forward in life. This research is not just for cancer patients, but for anyone who may one day be affected by cancer, whether personally or through a loved one. 

In addition to my survivorship research, I also lead the Healthcare Professional Academic Group (HPAG) at Imperial. HPAG is dedicated to building a supportive network for healthcare professionals, including nurses, midwives, allied health professionals, healthcare scientists, pharmacy staff, psychologists & clinical research practitioners (NMAHPPs), who engage in academic work. By fostering collaboration within and across disciplines, we aim to improve clinical care and research outcomes.