Navigating Cancer Survivorship: Challenges and Support Post-Treatment

Navigating Cancer Survivorship" (Caroline Knudsen and Chasse Bailey-Dorton, MD) Brad Power April 25, 2025 “Nobody knows what it's like to hear the word ‘cancer’ or go through treatment unless you've been there. I've been there. Most times in life, you feel bad, you go to the doctor, they do something to make you feel better. ” – Chasse Bailey-Dorton, MD “Survivorship has changed.

We now have folks who are going to be on treatment for the rest of their life. ” – Caroline Knudsen “My job is to load the boat with everything possible to help you without sinking the boat. Meaning: there's a lot of misinformation on the Internet. There's always somebody trying to sell you something. You face all your family and friends saying, ‘Well, I read this.

Cancer patients and caregivers face the often-overlooked challenges that survivors face, from lingering treatment side effects to emotional and lifestyle adjustments. In most cases, patients feel abandoned once active cancer treatment ends and lack guidance in their post-treatment journey. Chasse Bailey-Dorton, MD, and Caroline Knudsen are uniquely qualified to talk about the challenges of cancer survivorship. Dr.

Bailey-Dorton is the Co-Founder and Medical Director of The After Cancer. She's a 22-year breast cancer survivor, and has a background as a family practitioner and completed a fellowship in Integrative Medicine. She led the Integrative Oncology Department at Levine Cancer Institute (in Charlotte, North Carolina) for over a decade.

She currently guides The After Cancer's clinical approach and is the Director of Survivorship at First Health in Pinehurst, NC. Caroline Knudsen is the Co-Founder and COO of The After Cancer. Why do you need to pay attention to cancer survivorship? Cancer patients and their loved ones face numerous challenges after treatment that are often overlooked.

These include physical side effects like neuropathy and fatigue, psychological challenges such as fear of recurrence, and emotional struggles like feeling isolated or losing trust in one's body. Cancer-free doesn't mean healthy.

Survivors need ongoing support to manage symptoms, address mental health, navigate life changes, and develop strategies to “Navigating Cancer Survivorship" (Caroline Knudsen and Chasse Bailey-Dorton, MD) cope with the long-term impacts of cancer treatment.

Paying attention to survivorship helps patients and their loved ones regain a sense of control, improve qualit quality of life, and effectively manage the ongoing "elephant in the room" of cancer in their lives. What are the main issues that cancer patients and their loved ones struggle with post- treatment?

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Alen Amini We're really excited for the discussion that we'll have today, as I'm sure it's no secret to all of you, both patients and caregivers face often overlooked challenges, from treatment side effects, emotional lifestyle adjustments, and oftentimes, what that ends up doing for patients and their loved ones is invoking a feeling of abandonment. So we're very excited to have Dr.

Bailey- Dorton and Caroline Knudsen here today who are uniquely qualified to talk about the challenges of cancer survivorship. Dr. She led the integrative oncology department at Levine Cancer Institute for over a decade, and she currently guides The After Cancer’s clinical approach, and is the director of survivorship at First Health in Pinehurst, North Carolina. So we're very excited to welcome them.

Chasse Bailey-Dorton 1:58 Nobody knows what it's like to hear the word “cancer” or go through treatment unless you've been there. I've been there. Most times in life, you feel bad, you go to the doctor, they do “Navigating Cancer Survivorship" (Caroline Knudsen and Chasse Bailey-Dorton, MD) something to make you feel better. For cancer, the treatment we get makes us feel worse than when the whole thing started.

We're always wanting to know, “What can I do? Is there anything I can do to decrease the side effects? ” I went through those things myself, and that's what led me to an integrative medicine fellowship. There's always somebody trying to sell us something. They face all their family and friends saying, “Well, I read this. ” We have to make sure we're not interfering with the treatment that they have. We want to put that plan together.

Chasse Bailey-Dorton 3:59 This is something we modified that I found on the internet. This talks about this iceberg. We get to the end of treatment, and what people say is, “Oh, your hair is growing back. You're able to go back to work. You're back to normal. You're so strong. ” The neuropathy, the fatigue, the change in our body, the loss of trust in our body, and then this overwhelming fear of recurrence.

“Navigating Cancer Survivorship" (Caroline Knudsen and Chasse Bailey-Dorton, MD) I always describe it as “cancer is the big elephant in the room”. I'm 23 years out, and the elephant is still here. It's small, and it's in the corner, and there are times it wants to grow, and a lot of survivorship is learning how to control this elephant when it wants to grow, and we've got to process through what we've been through. Survivorship has changed.

Sometimes they feel like they don't fit in this paradigm that we have, but they're still dealing with a lot of the issues – these things that are under the water and the iceberg – that are not dealt with enough in our clinics and for our patients. We mentioned integrative oncology. This is how we deal with survivorship.

This is where integrative oncology starts, at diagnosis, getting in there and really addressing the physical, psychological, the social and the spiritual aspects of this patient. ” How do we optimize that healing process? How do we minimize the side effects? How do we maximize recovery? How can we decrease the risk of recurrence? There's a great analogy of mold in a basement.

You cut the mold out, you radiate the basement, you maybe put chemicals on the basement, but if you don't change the basement, mold is more likely to come back. How can we help decrease that risk? How can we give some control back to that patient so that they know they're doing something? How do we incorporate evidence- based complementary therapies? This gap is where The After Cancer is able to come in and address some of these issues.

“Navigating Cancer Survivorship" (Caroline Knudsen and Chasse Bailey-Dorton, MD) Caroline Knudsen 6:31 Cancer-free doesn't mean healthy , and that's what the birth of The After Cancer was from that realization and personal experience. And a clinician for Dr. Bailey-Dorton, as well as our co- founder and CEO, Marianna, who was a four time, eight times over, now cancer caregiver.

So what do we do in this space after cancer, and how can we support in that gap? Because the consequence is, all of us know of better cancer treatment, which is brilliant, but it does mean that there's more diagnoses, there's younger patients who are being identified earlier, and there's longer and higher survival rates.

And so there's an increasing population of patients w with all those needs we talked about, what's kind of under, under the surface there in the iceberg image, and our healthcare system hasn't caught up to really support in that space, and so that's the gap that we're trying to help fill at The After Cancer.

So this is a use case Mary, a 31 year old breast cancer survivor, but is just as true of all of the users who come to our platform, and this quote is really indicative of that experience as well. Is I'm more scared now than the day I was diagnosed, and it's really because in that space after treatment that really strong multidisciplinary team and support is gone, and patients are often having to navigate that alone.

So what we're trying to do with The After Cancer is help patients like Mary find evidence based answers to those day to day questions of all of the things we just saw earlier, but here, more specifically, in this use case, questions about drugs you're taking post treatment, so things like tamoxifen, and the impact that that has on patients, what to eat, nutrition, what's safe, what's not safe, questions about feeling isolated and lonely.

Loneliness is huge for people, and changing dynamics within relationships, and how to manage that.

We talked about fear of recurrence, how to manage fear of recurrence and really help patients live in between scans, and manage scan anxiety when those moments of monitoring come up, and then to manage those frequent questions that come up around both the physical as well as the psychosocial things that that are sort of day to day needs for survivors. So we do that with our virtual survivorship programs I mentioned a little bit earlier.

It's available in all 50 states. For us, it's really important increasing access to this kind of support. And so that digital first approach was was fundamental for us, “Navigating Cancer Survivorship" (Caroline Knudsen and Chasse Bailey-Dorton, MD) and these are sort of the core resources.

So there's personalized support to give guidance to patients on what they should be exploring in their own journey and also based on their interests and their own concerns that they self report. There's educational resources that are sort of available asynchronously, so they can do this whenever and wherever is convenient to delve in and learn more. There are group sessions. So this works just kind of like a gym membership.