Clinicians rightly celebrate when treatment ends. Yet many patients leave our clinics still carrying the invisible weight of illness—anxiety, low mood, pain, and a fragile sense of self. The evidence says this is not rare, and it is not trivial. A 2025 umbrella review of cancer survivorship found pooled prevalence rates of 33% for depression and 31% for anxiety, with higher figures during periods of wider societal stress. These symptoms shape adherence, function, and quality of life, long after the last dose.
Pain follows a similar pattern. Updated analyses suggest an overall pain prevalence of around 45% in people with cancer, with moderate–severe pain in roughly 31%—still a stubborn burden despite advances in treatment and supportive care. We already know what untreated pain and distress do: they worsen outcomes, increase health-care use, and erode the “survivorship” our treatments are designed to protect.
My point is simple: emotional recovery should be treated as a routine clinical outcome, measured and managed like any other. This does not require new clinics or heroic budgets. It requires making three basic practices non-negotiable in survivorship care.
1. Screen—Briefly and Consistently
The NCCN Distress Thermometer takes minutes, is available in dozens of languages, and has been recommended for routine use for years. Build it into discharge, and again at 30–90 days. Screening does not “medicalize” ordinary feelings; it makes them visible so we can triage support. In the same way that we check blood pressure at each visit, we can check distress and act on it.
2. Stratify
A positive screen should trigger a light-touch pathway: brief psychoeducation and self-management resources for mild scores; referral to psycho-oncology, pain, or rehabilitation services for moderate–severe scores; and urgent mental health input for red flags. This is standard clinical logic—what is often missing is an owner (who acts?) and a timeframe (by when?).
3. Offer practical, scalable adjuncts
Alongside established approaches (psycho-oncology, group CBT, mindfulness-based programs), immersive virtual reality (VR) is emerging as a non-pharmacological adjunct that can reduce pain and anxiety in oncology settings. Recent syntheses and randomized data report meaningful short-term reductions across these outcomes; the effect sizes vary, but the direction is consistent. VR is not a replacement for clinical care. It is one more tool—structured, time-limited, and deliverable by trained staff—to help patients regulate arousal, reconnect with their bodies, and practice skills that generalize outside the headset.
None of this diminishes the limits: not every patient will tolerate immersive tech (nausea, dizziness), and some will prefer human-led approaches. Equity matters; digital adjuncts must not widen gaps in access or attention. But as part of a stepped-care model, they can protect clinician time and offer patients something tangible when anxiety and pain feel abstract.
What will actually make this happen? In my experience working across clinics and research groups, four small governance decisions change everything:
- Name a clinical owner for recovery. Someone—often in psycho-oncology or survivorship—must be accountable for screening rates and follow-up, just as somebody owns VTE prophylaxis or antimicrobial stewardship.
- Put recovery on the dashboard. Include distress screening rates and follow-up actions in monthly quality reports, not as a “soft culture” item but as a care process indicator linked to outcomes.
- Time-box the first follow-up. “Positive screen” is not an action. “Positive screen → call within 7 days → intervention offered within 14 days” is an action.
- Pilot, don’t debate. Try a stepped-care bundle on one ward for 60–90 days: brief screening at discharge; a simple stratification plan; two adjunct options (e.g., group psychoeducation plus a short VR-supported relaxation protocol); and a small, defined metrics set (distress scores, pain scores, utilization). Review and adapt.
Some will ask whether we risk “medicalizing” recovery by measuring it. I would argue the opposite. We honor recovery by treating it as real work, worthy of the same discipline we give to wound care or anticoagulation. Our patients already do the work—at night, between scans, when the hospital is no longer watching. If we do not measure and support that work, we tacitly accept preventable suffering.
Cancer care has made extraordinary gains in survival. The next gains are in the quality of surviving. We do not need to reinvent survivorship clinics to begin. We can start tomorrow with one extra question, one owner, and one outcome on the dashboard. Survival is the beginning. Recovery should be the routine.
About Nargiz Noimann
Nargiz Noimann is the founder of X-Technology and a researcher with 25+ years in neuroscience and psychotechnology. She leads research programs on emotional and cognitive recovery after cancer, dementia, and other chronic conditions, and collaborates with clinicians to design and evaluate evidence-based, AI-supported virtual-reality interventions. She is currently partnering with UAE clinics to integrate these tools into routine care pathways, with a focus on measurable outcomes and patient dignity.
