Life After Cancer: Millions Living With Effects That Outlast Treatment

More people than ever are alive years after a cancer diagnosis: about 18.6 million in the United States and about 23.7 million across Europe, by the latest modelled estimates. Many live with effects of the illness or its treatment that last for years, among them fatigue, nerve damage, heart problems and reduced fertility, and the evidence shows that follow-up care has not kept pace.

Finishing treatment is often described as an ending. For many people it is the start of a different stretch of life: tired in a way sleep does not fix, hands or feet that still tingle, a heart that needs watching, plans for a family that have changed. The figures below show how many people are in that position and which long-term and late effects are best measured at population level. They describe groups, not any one person, and they show a gap between what people living after cancer report and the help they receive.

Tens of millions of people are living after cancer, and most were diagnosed years ago

Nobody counts people living after cancer directly. The figures are prevalence estimates, built from cancer registry records of who was diagnosed and who has since died, and then modelled. Two definitions matter. Complete prevalence counts everyone alive who has ever been diagnosed, however long ago. Limited-duration (or time-limited) prevalence counts only people diagnosed within a set window, such as the last five years, or since the registry began. Because registries started at different times, the gap between the two is filled by modelling.

In the United States, the American Cancer Society and the National Cancer Institute estimate prevalence every three years. Their 2025 report used the Prevalence Incidence Approach Model, combining SEER registry incidence and survival with national mortality and census data, and estimated about 18.6 million people living with a history of cancer on 1 January 2025^[1]. Nearly four in five (79%) were aged 60 or over; about half (51%) had been diagnosed within the past ten years, and 22% twenty or more years earlier^[1]. The most common diagnoses among them were breast (about 4.3 million women) and prostate cancer (about 3.6 million men)^[1].

In Europe, the EUROCARE-6 study used data from 61 cancer registries in 29 countries and the completeness index method to estimate complete prevalence for 2020: about 23.7 million people, 5.0% of the population^[2]. About 14.9 million of them had been diagnosed more than five years earlier, and about 9.1 million more than ten years earlier^[2]. Prevalence differed between countries by two to ten times depending on the cancer type^[2], reflecting differences in incidence, survival and population age. In the UK, Macmillan Cancer Support estimates almost 3.5 million people living with cancer in 2025, up from around 3 million in 2020; that estimate starts from time-limited prevalence for each UK nation, scales it to complete prevalence using a 2013 relationship, and projects forward^[3].

These three estimates use different models, years and inputs, so they are not directly comparable. All three count everyone who has ever been diagnosed, including people who were treated decades ago and may not think of themselves as living with cancer^[3]. For what survival figures do and don't mean, see our guide to survival statistics.

In the UK an estimated one in four people live with lasting effects; fatigue and nerve damage are among the most common

"Long-term effects" begin during treatment and carry on after it; "late effects" appear months or years later. Both are hard to count, because studies measure different effects, at different times, in different groups. Macmillan Cancer Support's working estimate, drawn from a 2013 report, is that one in four (25%) people with cancer in the UK are living with the long-term consequences of cancer or its treatment^[3]. It is a broad estimate, now more than a decade old, but it remains the most widely used UK figure.

Fatigue. A 2021 meta-analysis pooled 129 studies with about 71,600 people with cancer, published between 1993 and 2020. Overall, 49% reported fatigue; the figure was 62% among people in treatment and 51% in studies that mixed people during and after treatment^[4]. The review did not give a separate figure for people who had finished treatment, which is itself a gap in the evidence.

Nerve damage. Some chemotherapy drugs damage peripheral nerves, causing numbness, tingling or pain in the hands and feet. A meta-analysis of 31 studies with 4,179 people found chemotherapy-induced peripheral neuropathy in 68.1% in the first month after chemotherapy, 60.0% at three months and 30.0% at six months or more^[5]. The six-month estimate is uncertain (95% confidence interval 6.4% to 53.5%), but it points to a lasting effect for a substantial minority.

Memory and thinking. Problems with concentration, memory and processing speed after cancer treatment are often called cancer-related cognitive impairment. A 2014 review reported that up to 75% of people describe some form of it during treatment and that it persists in up to 35% many years after treatment ends; it also noted problems in up to 30% before chemotherapy began^[6], a reminder that the cancer itself, not only the treatment, may play a part. "Up to" figures are upper bounds across studies, not single estimates.

Lymphoedema and pain after breast cancer. The 2025 US report notes that lymphoedema (swelling, usually of the arm) affects at least 20% of people after removal of the lymph nodes in the armpit (axillary node dissection), compared with about 6% after the less extensive sentinel node biopsy, and that about a third of women develop persistent pain after breast cancer surgery or radiotherapy^[1]. The less extensive operation lowers the risk; it does not remove it.

Emotional effects, including depression, anxiety and fear of recurrence, are common too and are covered in our study of mental health with and after cancer.

Heart failure and blood clots occur at higher rates for years after several common cancers

Some cancer treatments can harm the heart and blood vessels, and the cancer itself and shared risk factors such as smoking may also play a part^[7]. A large population study linked UK primary care, hospital and cancer registry records for 108,215 adults diagnosed with one of 20 common cancers between 1990 and 2015 and alive a year later, and compared them with 523,541 people without cancer matched for age, sex and general practice^[7].

Heart failure or cardiomyopathy (disease of the heart muscle) occurred at a higher rate after 10 of the 20 cancers. Adjusted hazard ratios ranged from 1.59 after ovarian cancer to 3.29 after multiple myeloma, with non-Hodgkin lymphoma, leukaemia, lung, kidney and oesophageal cancer in between^[7]. Venous thromboembolism (blood clots in the veins) occurred at a higher rate after 18 of the 20 cancers, with hazard ratios from 1.72 after prostate cancer to 9.72 after pancreatic cancer; the ratios fell over time but were still raised more than five years after diagnosis^[7].

A hazard ratio compares the rate of a new condition over time in one group with another; a ratio of 2 means roughly twice the rate, not that half of people develop it. The study adjusted for shared risk factors such as smoking, body-mass index and existing conditions, and found this changed the ratios little; the excess appeared most pronounced in people who had received chemotherapy, but the study had no details of the drugs or radiotherapy doses given, so it could not say how much is due to treatment rather than the cancer itself^[7]. The point for services is that the excess is measurable, lasts for years, and differs by cancer type.

Effects on fertility and on people treated as children can last for decades

Treatment can reduce fertility, and the effect shows up at population level. A Scottish study followed all 23,201 women aged 39 or under diagnosed with a first cancer between 1981 and 2012 and compared them with women from the general population matched for age, deprivation and year. Women who had had cancer had 38% fewer pregnancies than expected (standardised incidence ratio 0.62), and the shortfall was seen for every cancer type, though for liver cancer (63 women) it did not reach statistical significance^[8]. The study counted pregnancies, not fertility itself, and had no details of the treatments women received, so it could not say how much of the shortfall was a direct effect of treatment^[8].

The longest view comes from people treated for cancer in childhood. In the US St Jude Lifetime Cohort, 3,010 adults who had been diagnosed at least ten years earlier were clinically assessed. By age 50, the cumulative incidence of any chronic health condition was 99.9%, and of a serious, disabling or life-threatening one (grade 3 to 5) 96.0%. On average they had 17.1 chronic conditions of any grade, including 4.7 serious ones, compared with 9.2 and 2.3 in community controls of similar age and sex^[9]. These people were treated decades ago, often with more intensive therapy than children receive today. Our study of children's and young people's cancer covers survival and late effects in this group in more detail.

Most people report concerns after treatment, and many do not get help

The clearest evidence on the gap between need and support comes from Canada. The national Transitions Study surveyed adults aged 30 and over, sampled from cancer registries in ten provinces, one to three years after treatment ended. Of 12,929 respondents, 87% reported at least one physical concern, 78% at least one emotional concern and 44% at least one practical concern^[10]. Among those who sought help, a third had difficulty getting it or did not receive it^[10]. Practical concerns include money and work, which our study of money and work after cancer covers.

A 2022 review in The Lancet concluded: "Current models of care are unsustainable and fail to address the many unmet needs of survivors of cancer"^[11]. Traditional follow-up focuses mainly on checking for recurrence, often through repeated specialist appointments, and less on long-term effects, symptoms and daily life. The review found that alternative models, including care led by primary-care providers, shared between specialists and primary care, or led by oncology nurses, appear to be at least as effective as specialist-led follow-up^[11].

Almost all of this evidence comes from high-income countries with good registries. In much of the world, there are no registry-based estimates like these and no systematic data on late effects at all.

What the evidence asks of us

The number of people living after cancer is growing where it is measured: projected to pass 22 million in the US by 2035^[1], and rising from around 3 million to almost 3.5 million in the UK in five years^[3]. The evidence points to four things services, funders and policymakers can act on.

• Plan for life after treatment as a phase of care in its own right. With most people diagnosed years ago^[1][2], follow-up built only around recurrence checks misses most of the need. The Lancet review calls for models that move away from a predominant focus on detecting recurrence^[11].
• Use the models that work, and share the load. Primary-care-led, shared and nurse-led follow-up appear at least as effective as specialist-led care^[11]. Commissioners can fund them, with clear routes back to specialists when needed.
• Make known risks part of routine planning. Higher rates of heart failure and blood clots that last for years^[7], lasting nerve damage^[5] and reduced fertility^[8] are measurable at population level. Health systems can use them to decide who is offered longer-term monitoring, information or fertility services, instead of leaving people to raise problems themselves.
• Count what happens after treatment. Registry-based prevalence estimates exist for a minority of countries, and the UK's figure on long-term consequences dates from 2013^[3]. Registries, national surveys such as Canada's Transitions Study^[10] and funders of research can make late effects and unmet need routinely measured, in more countries and in more groups.

The gap shown here is not in the people reporting fatigue, pain or worry. It is in services that were designed for a time when fewer people lived for long after cancer.

Language: this piece says "people with cancer" and "people living with and after cancer", and describes the illness and its treatment plainly, without combat metaphors. Clinical terms such as "stage", "incidence" and "net survival" are used in the sense the cited source defines them.

Why we're publishing this

Charities, support groups and hospices hear every day from people who finished treatment and found that the effects did not finish with it. Too often they are told this is to be expected, and left to manage on their own. The figures here show that these experiences are common, measurable and, in large part, predictable, which means services can plan for them. We have gathered the best available population evidence in one place so that the people and organisations making that case can cite it. The case is theirs. This study is part of our cancer research library.

How to read this data

The prevalence figures are modelled estimates from cancer registries, not head counts; each uses a different model, year and set of inputs, and they should not be compared as if they were one series. They count everyone ever diagnosed, including people treated long ago. The figures on effects come from different study types: meta-analyses that pool many smaller studies (fatigue, nerve damage), a review giving upper-bound ranges (cognitive effects), linked health-record cohorts (heart and blood clots, fertility), a clinically assessed cohort from one US hospital (childhood cancer) and a national survey with a one-in-three response rate (Canada). Pooled prevalence figures vary widely between the studies behind them. Hazard ratios and standardised incidence ratios are relative measures: they say how much more common something is than in a comparison group, not how many people are affected. Almost all of the evidence comes from North America, Europe and Australia; we found no comparable population data for most low- and middle-income countries. We could not verify a current global prevalence figure at source, so none is given.

Use this data

Free to cite with attribution to Better Health For Everyone. Charities, campaigners and journalists are welcome to reuse these figures and charts. For the underlying figures as a spreadsheet, get in touch.

Important: This article summarises published research for general information. It is not medical advice and cannot be used to diagnose, treat or predict anything about an individual. If you have concerns about your own or someone else's health, please speak to a qualified health professional.

Sources

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2. De Angelis R, Demuru E, Baili P, et al. (EUROCARE-6 Working Group). Complete cancer prevalence in Europe in 2020 by disease duration and country (EUROCARE-6): a population-based study. The Lancet Oncology, 2024;25(3):293-307. europepmc.org/article/MED/38307102
3. Macmillan Cancer Support. Cancer statistics in the UK (cancer statistics fact sheet), updated February 2026. Macmillan Cancer Support, 2026. macmillan.org.uk/about-us/what-we-do/research/cancer-statistics-fact-sheet
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9. Bhakta N, Liu Q, Ness KK, et al. The cumulative burden of surviving childhood cancer: an initial report from the St Jude Lifetime Cohort Study (SJLIFE). The Lancet, 2017;390(10112):2569-2582. europepmc.org/article/MED/28890157
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