It's not over when it's over: long-term symptoms in cancer survivors--a systematic review

Int J Psychiatry Med. 2010;40(2):163-81. doi: 10.2190/PM.40.2.c.


Background: The number of cancer survivors is steadily increasing. Following completion of primary cancer treatment and many years thereafter, specific symptoms continue to negatively affect cancer survivors. The purpose of this article is to review the evidence of symptom burden following primary treatment for cancer in survivors of the most common types of cancer (breast, gynecological, prostate, and colorectal).

Methods: A systematic review of literature published between the years 2000-2008 that reported late-effects and/or long-term psychosocial symptoms associated with cancer survivorship post-completion of primary cancer treatment was conducted. The symptoms include physical limitations, cognitive limitations, depression/anxiety, sleep problems, fatigue, pain, and sexual dysfunctions.

Results: Symptom burden associated with cancer survivorship was consistent among the four most common types of cancer (breast, gynecological, prostate, and rectal/colon), despite various types of treatment exposure. Generally, across the cancer groups, depressive symptoms, pain, and fatigue were commonly found in cancer survivors.

Conclusions: Based on longitudinal and cross-sectional evidence, cancer survivors can experience symptoms for more than 10 years following treatment. These symptoms were present in survivors of all four cancer types who underwent a wide variety of treatment. The results indicate that these symptoms should be evaluated and managed to optimize long-term outcomes.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Anxiety / epidemiology
  • Anxiety / psychology
  • Breast Neoplasms / psychology
  • Breast Neoplasms / therapy
  • Cognition Disorders / epidemiology
  • Cognition Disorders / psychology
  • Colorectal Neoplasms / psychology
  • Colorectal Neoplasms / therapy
  • Cost of Illness
  • Cross-Sectional Studies
  • Depression / epidemiology
  • Depression / psychology
  • Fatigue / epidemiology
  • Fatigue / psychology
  • Female
  • Genital Neoplasms, Female / psychology
  • Genital Neoplasms, Female / therapy
  • Humans
  • Longitudinal Studies
  • Male
  • Neoplasms / psychology*
  • Neoplasms / therapy*
  • Pain / epidemiology
  • Pain / psychology
  • Prospective Studies
  • Prostatic Neoplasms / psychology
  • Prostatic Neoplasms / therapy
  • Sexual Dysfunction, Physiological / epidemiology
  • Sexual Dysfunction, Physiological / psychology
  • Sleep Wake Disorders / epidemiology
  • Sleep Wake Disorders / psychology
  • Survivors / psychology*