Life after cancer: Why survivorship, access and continuity of care matter as much as treatment

Cancer is still the leading cause of death globally, and in South Africa, surviving cancer is too often determined not by the disease itself but by access to timely diagnosis, treatment and ongoing care.

While global cancer survival rates continue to improve, local outcomes tell a more unequal story: with survival rates in South Africa significantly lower than in many high-income countries, particularly for cancers that are highly treatable when detected early.

As the world marks Cancer Survivors Day on 4 June, the focus is shifting beyond treatment alone but to survivorship, continuity of care, and the systemic challenges that shape who survives and who doesn’t. This is according to Dr Renata Maharaj, head of Medical Affairs at Novartis South Africa.

She adds: “The reality is that to improve cancer outcomes, healthcare must be people-centred and sensitive to patients’ perceptions, lived realities and information needs”.

Research shows that early-stage cancer detection can increase survival rates, yet many South Africans are still diagnosed at advanced stages, where survival drops dramatically. Barriers such as delayed diagnosis, limited access to oncology specialists, and fragmented healthcare systems continue to impact patient outcomes across the country.

“From a clinical perspective, the difference between early and late diagnosis is often the difference between life and death,” says Dr Maharaj. “We know that when patients are diagnosed early and have consistent access to treatment and follow-up care, outcomes improve significantly. But too many patients in South Africa enter the system late, when treatment options are more limited and less effective.”

Even after successful treatment, the risk does not end. Cancer recurrence remains a significant concern for survivors. Evidence shows that many recurrences occur within two to five years following treatment – more specifically with a 30% recurrence risk for breast cancer.

“Patients often believe that once treatment ends, the cancer journey is over, but clinically, that’s not the case,” says Dr Maharaj. “The risk of recurrence is real, and without regular checkups, surveillance and in some cases ongoing therapy, cancer can return undetected until it is more advanced and harder to treat,” she reiterates.

“Cancer is like a moving target, making it hard for any treatment to capture and kill all cancerous cell. For example, surgery to remove a cancerous tumour may miss some cells because they were too small to detect. Cancer constantly evolves as cells mutate and change. In some cases, cancer treatment may not work against all cancer cells. Those cells can keep growing despite treatment until a healthcare provider detects them during follow-up examinations.”

Beyond diagnosis, continuity of care remains a critical and often overlooked factor in survivorship. Cancer is increasingly being managed as a chronic condition, requiring long-term monitoring, management of side effects, and sustained access to medication and support services.

Certain studies have shown that patients who receive uninterrupted, guideline-consistent care have markedly better survival outcomes. However, in South Africa, gaps in the healthcare system – including long waiting times, resource constraints and disparities between public and private care – can disrupt treatment pathways and negatively impact long-term survival.

“Access to care is one of the most significant determinants of cancer outcomes,” says Sanjay Govender, interim head of Value and Access at Novartis South Africa. “When patients can access the right treatment at the right time and continue that care without interruption, their chances of survival improve dramatically. Addressing barriers to access is not just a healthcare issue – it’s a matter of equity.”

Survivorship also brings its own challenges. Many patients face ongoing physical complications, psychological stress and financial strain long after treatment ends. Without structured survivorship programmes and support systems, these challenges can affect both quality of life and long-term health outcomes.

Cancer Survivors Day serves as a reminder that cancer care does not end when treatment stops.

“Improving survival rates in South Africa will require a more integrated, patient-centred approach: one that prioritises early detection, strengthens healthcare systems and ensures equitable access to care across the entire patient journey,” Dr Maharaj concludes.

Image credit: Magnific