On a quiet morning at the University of British Columbia’s cancer survivorship clinic, Maya Fernandez sits by the window, watching sailboats drift across English Bay. At 32, she’s been cancer-free for seven years, but freedom from her disease hasn’t meant freedom from its shadow.
“People think surviving cancer is the happy ending,” she tells me, her fingers tracing the rim of her coffee cup. “They don’t see what comes after—the anxiety that never quite leaves, the way your body feels like it might betray you again at any moment.”
Maya represents a growing cohort of young adult cancer survivors facing a reality that researchers are only beginning to fully document: the mental health aftermath of cancer can persist for decades, affecting everything from relationships to career trajectories and sense of self.
A groundbreaking study published last week in the Journal of Clinical Oncology confirms what Maya and thousands like her have experienced. Researchers tracking young adult cancer survivors over 25 years found they experience significantly higher rates of anxiety, depression, and post-traumatic stress compared to peers who never faced cancer—with many mental health challenges persisting decades after treatment ended.
“We’re seeing that cancer during young adulthood creates a distinct psychological footprint,” explains Dr. Sylvie Richardson, a psycho-oncologist at BC Cancer who wasn’t involved in the study but works with young adult survivors daily. “These individuals face cancer during critical developmental years when they’re forming their identities, starting careers, and building relationships.”
The study followed over 4,000 cancer survivors diagnosed between ages 18-39 and compared them with age-matched controls without cancer histories. Alarmingly, survivors showed 37% higher rates of anxiety disorders and 42% higher rates of clinical depression even 20+ years after diagnosis. Perhaps most striking was that mental health support typically tapered off within two years post-treatment, long before many psychological challenges fully manifested.
Walking through downtown Vancouver’s False Creek Seawall, I meet with three members of Young Adult Cancer Canada’s local chapter. Their weekly walks offer what formal healthcare often doesn’t—ongoing psychological support from others who truly understand.
“Cancer at 25 feels like having your future stolen and then handed back with fine print you can’t quite read,” says Jordan Kim, diagnosed with Hodgkin’s lymphoma six years ago. “I’m grateful to be alive, but I live with this constant undercurrent of uncertainty that friends my age just don’t understand.”
The study identified specific mental health challenges unique to young adult survivors. Many described “survivor guilt,” intensified by watching friends with similar diagnoses die. Others detailed a phenomenon researchers termed “developmental isolation”—feeling perpetually out of sync with peers who continued normal life progressions while they fought for survival.
Statistics Canada reports approximately 8,000 young adults between 18-39 are diagnosed with cancer annually across Canada. While medical advances mean roughly 85% will survive five years or longer, our healthcare system remains poorly equipped to address their long-term mental health needs.
Dr. Aisha Patel, an oncology researcher at the University of Toronto who studies survivorship issues, explained by phone: “Our cancer care systems are still primarily designed around immediate treatment success. We’re excellent at saving lives but struggling to help survivors rebuild those lives afterward.”
The study findings align with what Indigenous communities have long understood about health. During my reporting on cancer survivorship among First Nations communities in northern British Columbia last year, Elder Margaret Wilson of the Gitxsan Nation told me: “Healing isn’t just about the body. The spirit and mind must heal too, and that healing follows its own timeline.”
This holistic perspective is slowly gaining traction in mainstream healthcare. At Vancouver General Hospital, a pilot program launched last fall offers integrated psychological support for young adult survivors, extending mental health services to five years post-treatment rather than the standard six months.
The program’s director, Dr. Thomas Chen, emphasizes this shift: “We’re finally recognizing that cancer survivorship is a lifelong journey, not a finish line. Mental health support shouldn’t end when physical treatment does.”
For Maya Fernandez, finding appropriate support has meant cobbling together resources—a cancer survivorship group at the university, private therapy she can barely afford, and online communities connecting her with other young survivors.
“The hardest part is explaining to people that being cancer-free doesn’t mean being free of cancer’s effects,” she says. “I’m still healing, and I probably always will be.”
As we continue to advance cancer treatments, the new research underscores an urgent need to reimagine survivorship care—particularly for young adults who may live with cancer’s psychological aftermath for decades. The Canadian Mental Health Association and Canadian Cancer Society have recently announced a joint initiative to develop specialized resources for this growing population.
The message from researchers and survivors alike is clear: defeating cancer is just the beginning of recovery, not its conclusion. For young adults like Maya, Jordan, and thousands of others across Canada, true healing requires ongoing support that honors both visible and invisible scars—a healthcare approach that recognizes survival as a continuing journey rather than a singular event.
As Maya puts it while watching those distant sailboats navigate the changing tides: “I’m learning that surviving isn’t just about making it through the storm. It’s about learning to sail in uncertain waters for the rest of your life.”
