When the Early Career Cancer Nurses Working Group within the European Oncology Nursing Society first began discussing survivorship, we noticed something important: although we all used the term, we did not always share the same understanding of it. That realisation became the starting point for our qualitative study exploring how early career cancer nurses across Europe interpret and deliver survivorship care.
We asked a simple question: what does cancer survivorship look like from the perspective of early-career nurses?
What we found was not a lack of commitment to survivorship care, but a lack of clarity, preparation, and system-level support. Many participants agreed, in principle, that survivorship begins at diagnosis. Yet in everyday clinical practice, it was often only discussed after treatment had ended. Some nurses working in tumour groups with poorer prognoses rarely used the term at all. Others found they had to look up definitions to understand how survivorship related to their own roles.
These perspectives highlight a gap between how survivorship is described in policy and literature, and how it is experienced in clinical environments. Nurses were already supporting patients across the whole cancer continuum, but they did not always recognise this work as survivorship care.
The Emotional Dimensions of Survivorship
A strong theme in the findings was the emotional complexity of survivorship. Nurses described patients whose greatest fears were not always related to cancer itself, but to poverty, loneliness, and the sudden loss of structured support once treatment ended. Family caregivers were also central to their reflections, with some giving up employment or taking on significant responsibilities with limited recognition or practical help.
Nurses spoke candidly about their own emotional experiences: feeling unprepared for tough conversations, being affected by patient deaths, and utilising informal peer support to cope. For many, survivorship care extended far beyond managing late physical effects, it involved navigating uncertainty, fear, and social challenges alongside patients and families.
Barriers and Opportunities
Across different countries and services, nurses described limited autonomy in follow-up care, physician-led systems that restricted their involvement, and unequal access to survivorship resources. They emphasised the need for clearer definitions, tiered education, and better recognition of the nursing contribution across the survivorship pathway. Importantly, they argued that survivorship education should not be specialist, optional content, but part of core nursing preparation.
What This Study Offers
This study does not propose a new model of survivorship. Instead, it provides insight into how survivorship is understood by the nurses delivering care every day, particularly those early in their careers, who see both the strengths and the gaps in current systems.
Ultimately, before survivorship care can be improved, we need shared definitions, better preparation, and stronger support for nurses. As the participants reminded us, survivorship is not a phase after cancer, it is woven throughout the entire cancer journey, if we choose to recognise it.
For more information, please see the full research paper, published here:
Dr Mark Dornan
Early Career Nurses Working Group