Today, more people than ever are living beyond cancer diagnosis. Across the United States, over 19 million people are cancer survivors, and that number is expected to reach 26 million by 2040. Advances in early detection and treatment have improved survival rates, allowing people to live longer after diagnosis.
As the survivor population grows, the focus of research and cancer care is shifting to a new question: How can survivors live well after cancer?
“Survivorship care is evolving toward more personalized approaches that address long-term physical, cognitive and emotional needs,” said Dr. Vijaya Raj Bhatt, co-leader of the Cancer Prevention and Control Program at the Fred & Pamela Buffett Cancer Center. “Today, survivorship care focuses on helping people manage life after cancer through personalized care plans, healthy lifestyle guidance, mental health support and coordinated care among healthcare providers.”
Helping survivors thrive after treatment
For many survivors, cancer challenges do not end when treatment finishes. Fatigue, changes in memory and thinking, emotional distress, fertility concerns, and maintaining independence can affect quality of life for years after diagnosis.
To address these needs, survivorship research at the Fred & Pamela Buffett Cancer Center is expanding to better serve groups that have received less attention, including older adults, people with advanced cancer, and younger survivors concerned about fertility.
Older adults represent nearly two-thirds of all cancer survivors in the United States, making them an important focus of survivorship care.
“Older adults highly value preserving independence, cognitive function and mobility,” said Dr. Bhatt. “Care models that include assessments of frailty, rehabilitation and supportive services can help achieve these goals.”
One recent study examined memory and thinking abilities in older adults undergoing stem cell transplantation. Researchers found that evaluating cognitive health before treatment may help identify patients at greater risk for decline, allowing healthcare teams to provide support earlier and help survivors maintain their independence and quality of life (Koll et al., 2025).
Survivorship science is also expanding to support people living with advanced or metastatic cancer. Increasingly, survivorship programs recognize that supportive care can improve quality of life regardless of where someone is in their cancer journey (Brown et al., 2025; Jefford et al., 2025).
Researchers are also addressing concerns that affect younger survivors (Bergerot et al., 2026). One emerging area of study focuses on fertility preservation, examining how cancer therapies damage oocytes at a molecular level—work that may inform strategies to better protect reproductive function in young female survivors (Song et al., 2025).
New research approaches to improving quality of life
In a predominantly rural and frontier state, helping survivors live well after cancer often requires new care approaches. Research shows structured physical activity programs can reduce fatigue and improve quality of life among cancer survivors (KC et al., 2025). Yet, rural survivors are less likely to be active and more likely to experience psychological distress and barriers to specialized care (Page et al., 2023; Kumar et al., 2026).
One effort to address these challenges is the multi-center COACH study, which is testing digital health coaching across six National Cancer Institute-designated cancer centers. The study aims to help cancer survivors achieve personalized health and wellness goals after treatment, regardless of where they live (Lally et al., AACR Annual Meeting, 2025; NCT05349227).
“Projects like this are important to understand what is feasible and most beneficial for cancer survivors. Survivors can expect to see more hybrid online guided, independent online, and in-person support as this science has been growing for over a decade,” said Dr. Robin Lally, director of the Center for Chronic Illness, Self-Management and Prevention at the UNMC College of Nursing.
The Fred & Pamela Buffett Cancer Center researchers are working on a portfolio of survivorship studies with a combined enrollment goal of approximately 500 participants over five years. Together, these studies are exploring ways to improve physical function, recovery, emotional well-being and overall quality of life for cancer survivors.
Current studies include:
- A virtual exercise and health coaching program designed to help blood cancer survivors age 50 and older stay active and maintain their independence, with one-third of participants recruited from rural communities (HALT Aging-1).
- Tracking physical function and quality-of-life changes in older adults with blood cancers during their first year of treatment to better understand how survivors can be supported throughout recovery (ROAR-1).
- Evaluating treatment approaches for graft-versus-host disease and their impact on quality of life among older adults undergoing stem cell transplantation (PTCY).
- Examining whether early nutritional support can reduce complications and improve recovery following stem cell transplantation (ENABLE-1).
- Combining exercise, nutrition and psychological support to improve the well-being of long-term survivors of solid tumors (Multimodal Supportive Care Trial).
- Assessing changes in cognition before and after CAR-T cell therapy in older adults with myeloma (ONC690-25).
- Examining the prevalence of obesity and its behavioral drivers across Nebraska communities to identify opportunities for cancer risk reduction (RESILIENCE).
- Investigating whether a structured physical activity program can preserve or improve cognitive function in older adults undergoing stem cell transplantation (PROACTIVE).
- Characterizing gut microbiome diversity in breast cancer survivors within the first year after completing active therapy, including comparisons by treatment type and menopausal status (ONC663-23).