The psychological and emotional fallout of cancer and its treatment.

We review the literature on psychosocial and emotional adjustment for individuals who have survived cancer for at least 5 years and who have not experienced recurrences of the disease. Most long-term survivors experience low levels of distress and report overall emotional adjustment that is comparable with age-matched comparisons who never had a cancer diagnosis. However, survivors frequently have circumscribed areas of persistent difficulties, including fears of recurrence and psychological reactions to the physical dysfunction and disfigurement caused by some treatments. Although some common themes emerge, there is considerable variation in response to cancer and its treatments, which the literature suggests can be predicted, in part, by disease- and treatment-related factors, individual characteristics, and psychosocial resources. Understanding the emotional and psychosocial experiences of the millions of long-term cancer survivors is essential for providing them with optimal care.