How to Survive Cancer: What Cancer Survivors Did to Improve Survival

November 26, 2023

By Angie N Choi, EdD, Author of Whole New Me: Healing From Cancer in Body, Mind, and Spirit

There are more cancer survivors than ever before. In January of 2022, there were 18,060,100 million cancer patients or survivors who were still alive in the United States.¹ The term cancer survivor designates a broad group of people who have ever had a cancer diagnosis. Survivorship is now categorized into three phases.¹

1. Time from diagnosis to the end of initial treatment
2. Long-term survival.
3. Transition from treatment to extended survival

Table 1 illustrates that the majority of male and female cancer survivors are living from 10 to 15 years and some more than 30 years.¹

When it comes to surviving cancer, oncologists often quote survival rates that come from the National Cancer Institute’s SEER (Surveillance, Epidemiology, and End Results) population database.² These statistics compare whether those with the same type of cancer and stage are still living 1,3,5, or 10 years later compared to the general population’s mortality rates.³ Although informative, these rates do not provide any information about how people actually survived cancer though data on the types of standard treatments is available. Another issue is that few cancer research studies focus on quality-of-life years later and merely report whether patients are still living instead.

Given that more people are surviving cancer for longer, there is a greater need for further studies focusing on cancer survivorship. It would be beneficial to know how people are living after cancer, but also how patients survived it for prevention. After getting diagnosed with cancer, most people want to know how to survive cancer from those who actually survived it. In this article, we’ll discuss research findings from several studies and literature reviews that may be helpful to those who have been diagnosed or want to prevent cancer.

How people survived cancer

In a population study on cancer survivors and statistics, data from the National Cancer Database, a hospital-based cancer registry that includes greater than 70% of all invasive cancers from more than 1500 facilities, indicated that most survivors underwent the following treatments.⁴

1. Surgery
2. Radiation
3. Chemotherapy
4. Targeted therapy
5. Hormonal therapy
6. Immunotherapy

Depending on the type of cancer and stage, different combinations of standard treatments were used. For example, half of early-stage breast cancer survivors had breast-conserving surgery with radiotherapy, whereas 65% of those with stage III breast cancer underwent mastectomy and chemotherapy. In another study on breast cancer survivors, refusing surgery in breast cancer resulted in 2.1X increased risk of death compared to those who didn’t refuse surgery.⁵

For nonsmall cell lung cancer survivors in stage I or II, more than half had surgery to partially remove a lobe of the lung or one lung entirely whereas only 21% of stage III patients underwent surgery. Most stage III survivors were also treated with chemotherapy or radiation.⁴

One of the most notable factors for improving survival from cancer in the literature was early detection.⁶ Diagnosing cancer at earlier stages increased the probability of providing optimal treatment which improved chances for survival. Given that, cancer screening continues to be an invaluable tool in improving survival rates.

In a study comparing exceptional survivors’ well-being (those who had survived at least 5 years after diagnosis despite having less than 25% chance of living that long given their tumor site and stage) to control survivors (5 -year survivors at an early stage of cancer), groups differed on cancer site and treatment.⁷ Exceptional survivors were more likely to have had stomach or lung cancer and received chemotherapy or radiation than control survivors who were more likely to have had breast cancer and undergone surgery. Findings indicated that exceptional survivors were doing well compared to control survivors, though the study did not evaluate side effects from treatment. For example, some prostate cancer survivors experienced impotence but these effects were not assessed in this study. Nonetheless, exceptional survivors were generally doing well. Another finding indicated that all cancer survivors had high levels of resilience but not optimism. Although control survivors had cancers in earlier stages than exceptional survivors, they were not more optimistic. A cancer diagnosis was overwhelming for both groups. The experience of cancer helped both groups develop the will to live and a deeper meaning to life. They also found that psychological factors explained differences in well-being and that objective disease states were less significant than personal values. These findings suggest that individual values and characteristics matter despite proliferative tumor sites or advanced stages. As evident in other studies, finding a meaningful purpose was a key component of surviving cancer.

Lifestyle and psychoemotional changes to survive cancer

Beyond standard treatments for cancer, several research studies indicated that lifestyle, psychoemotional, and spiritual factors helped cancer survivors persist and even thrive.  In a qualitative study of mostly advanced-stage ovarian cancer survivors, the authors found three main reasons for how these women survived.⁸

1. Improved lifestyle not limited to fitness and diet
2. Strong support systems that included family, friends, support groups, faith communities, and healthcare workers
3. Strong life purpose that included positivity, taking control of their lives, and advocating for themselves

Results from another study on ovarian cancer survivors (n=200) who had not been in treatment for at least two years indicated similar findings.⁹ Having survived a life-threatening ordeal put challenges into perspective and increased survivors’ resilience. Cancer had a positive effect on their relationships with children, partners, and others.  Although some women had negative feelings overall about the impact of cancer on their lives, the majority reported an overwhelmingly positive impact.

Lifestyle factors have been increasingly associated with decreased cancer mortality rates. Changing to healthier lifestyle habits reduces the risk of cancer recurrence. According to Vijayvergia and Denlinger, there were several lifestyle factors that impacted positive health outcomes for survivors.¹⁰

1. Weight management
2. Dietary change and supplements
3. Physical activity
4. Smoking cessation.

Another well-cited lifestyle factor for cancer survivorship was physical activity. In a literature review of 45 studies, consistent evidence from 27 observational studies indicated that physical activity was associated with reduced breast and colon cancer deaths. The authors suggested that physical activity may result in positive changes in insulin levels, insulin-related pathways, inflammation, and possibly, immunity.¹¹

Eating a healthy diet was also associated with better survival rates. A healthy diet which comprised of 5 servings daily of fruits and vegetables and physical activity of walking 30 minutes 6 days weekly was associated with 50% decrease in mortality 7 years later.¹²

Survivors who stopped smoking were more likely to live longer than those who didn’t. In a 2013 literature review, smoking cessation decreased recurrent and secondary tumors. Patients who smoked were approximately 3 times more likely to die from cancer than those who stopped smoking; however, patients who stopped smoking lowered pneumonitis and infections from radiation, and lengthened survival rates after chemotherapy and radiation for small-cell lung cancer survivors.¹³

Another important factor in surviving cancer was having emotional and social support. In a study on breast cancer survivors, women with more social support had less risk of mortality after a breast cancer diagnosis than those who were isolated. Isolated women had less access to caregiving from family and friends.¹⁴

Childhood or young adult cancer survivors

Research focused on childhood or young adult cancer survivors pointed to similar themes across several studies. A study on the lived experience of Latino adolescents and young adults at least one year after cancer indicated that optimism, relationships with loved ones and healthcare professionals, and resilience throughout cancer treatment were key themes that helped them survive cancer.¹⁵ Another study on Korean childhood cancer survivors indicated four main ways they experienced growth after cancer.¹⁶

1. Being content with the present
2. Using self-affirmations
3. Deepening faith
4. Finding the social meaning of cancer (mapping out a career pathway or becoming an advocate)

This study suggests the importance of finding one’s place in the social sphere as an important motivation to survive cancer, especially for younger survivors. Older survivors have more life experience and find meaning in their cancer experience, but younger survivors lack life experience and need to identify viable social pathways (career, relationships, etc.) as cancer survivors. Researchers in another study on young adult survivors and their family members found that cancer was a transformative health experience with positive transformations in three main areas.¹⁷

1. Perspective on health
2. Proactive health behavior changes
3. More open communication about wellness

Complementary and alternative medicine therapies use in cancer survivors

Complementary and alternative medicine (CAM) are therapies that many cancer survivors use in addition to conventional cancer treatment. According to the National Center for Complementary and Alternative Health, when a patient uses a non-mainstream approach with conventional medicine, it is considered complementary medicine, and when it is used in place of conventional medicine it is called alternative. Additionally, integrative health/medicine or functional medicine is when a patient uses both conventional and complimentary approaches together in a coordinated way.

In a 2010 population-based study on CAM use in cancer survivors, researchers found that 66.5% (n=1471) of survivors reported ever using CAM.¹⁸ They used CAM for several reasons listed in order of most cited.

1. Improve general wellness.
2. Enhance energy.
3. Improve immune function.
4. Decrease physical pain.
5. Treat psychological pain.
6. Address insomnia.

Results also indicated that the majority of cancer survivors were not communicating CAM use to their conventional doctors which could be problematic as some CAM therapies pose medication interactions.

Personal experience with an integrative health approach

As a personal example, I used an integrative health approach to treating cancer. I viewed cancer as a chronic disease that had physical and mental dimensions. I wanted to figure out what was happening with my health systemically rather than just looking at cancer as just a disease (pathology) to treat. I needed to get to the root cause of the conditions that allowed cancer to flourish and address those to let both body and mind heal.  To do so, I used an integrative health approach for my cancer treatment. I had conventional doctors for standard medical care (surgery, scans, labs), a naturopathic doctor to improve overall wellness (immune system, gut microbiome, detoxification, detailed lab work, monitoring) and to be my main detective piecing everything together, a ketogenic nutritionist (ketogenic diet for cancer), yoga therapy (postures, breathing practices, contemplation, meditation), physical therapy (cupping, breaking down scar tissue, improving blood flow), and an integrative oncologist (metabolic approach to cancer) as well. I was in the center of all these treatments coordinating my care, and with every consultation, blood draw, scan, or therapy, I gained greater insight into my overall health. It was an empowering, positive experience.

How spontaneous remission survivors’ cancer disappeared

An intriguing group of cancer survivors to study is those who experienced radical or spontaneous remission of cancer. Spontaneous remission is defined as the disappearance of cancer without medical treatment or with medical treatment that is inadequate to produce cancer’s disappearance.¹⁹ The terms radical or spontaneous are likely misnomers because healing is occurring but in a way that is not understood.

In a grounded theory study aiming to collect hypotheses for spontaneous remission, six common themes for spontaneous remission emerged from interviews with 20 radical remission cancer survivors and 50 non-conventional healers.²⁰ The study identified six main themes.

1. Dietary change
2. Spiritual connection
3. Increasing positive emotions
4. Releasing suppressed emotions
5. Taking herbs/vitamins/supplements
6. Following intuition

Additionally, three other themes came up frequently for the cancer survivors: 1) taking control of healing decisions, increased social support, and 3) having a strong reason to live.

In this same study, interesting observations were noted by non-traditional healers.¹⁹ One healer from Japan shared that cancer cells were not malignant cells but delinquent cells that adapted to faulty conditions where normal mitochondria become impaired and then turn into cancer. According to the healer, cancer hardly ever occurred in the heart or small intestine because these organs were warm and had high blood and oxygen content. Another healer shared that humans have a physical body and also subtle bodies (energy body, mental/emotional body, causal body) that are connected. Good health occurs when energy is flowing (akin to blood circulating to provide oxygen and nutrients in the physical body) through these bodies, but when energy gets blocked or stuck, disease occurs. Another healer shared that alexithymia (difficulty in identifying, processing or expressing emotions) was the main cause of cancer. Alexithymia caused blood pressure and body temperature to go down because emotions were not being expressed.

In summary, early detection is a key reason for how cancer patients survive cancer. Most survivors use some type of standard cancer treatment and lifestyle changes for improved health and longer survival. Lifestyle is increasingly associated with improved health outcomes for patients and is a promising area for further research on extended and long-term survivors. More cancer survivors are using complementary and alternative medicine for overall wellness. Psychological and spiritual growth and social support are other key factors in surviving cancer.

References

¹American Cancer Society. Cancer Treatment & Survivorship Facts & Figures 2022-2024. Atlanta: American Cancer Society; 2022.

²Surveillance, epidemiology, and end results program. National Cancer Institute. https://seer.cancer.gov/.

³Surveillance, epidemiology, and end results program. National Cancer Institute. SEER*Explorer Application (cancer.gov)

⁴Miller KD, Nogueira L, Devasia T, et al. Cancer treatment and survivorship statistics, 2022. CA Cancer J Clin. 2022;72(5):409-436.

⁵Verkooijen HM, Fioretta GM, Rapiti E, Bonnefoi H, Vlastos G, Kurtz J, et al. Patients’ refusal of surgery strongly impairs breast cancer survival. Annals of Surgery. 2005 Aug;242(2):276

⁶Hiom SC. Diagnosing cancer earlier: reviewing the evidence for improving cancer survival. British Journal of Cancer. 2015 Mar 31;112:S1-5.

⁷Gotay CC, Isaacs P, Pagano I. Quality of life in patients who survive a dire prognosis compared to control cancer survivors. Psycho‐Oncology. 2004 Dec;13(12):882-92.

⁸Alimujiang A, Khoja L, Wiensch A, Pike MC, Webb PM, Chenevix-Trench G, et al. “I am not a statistic” ovarian cancer survivors’ views of factors that influenced their long-term survival. Gynecologic Oncology. 2019 Dec 1;155(3):461-7.

⁹Stewart DE, Wong F, Duff S, Melancon CH, Cheung AM. “What doesn’t kill you makes you stronger”: an ovarian cancer survivor survey. Gynecologic oncology. 2001 Dec 1;83(3):537-42.

¹⁰Vijayvergia N, Denlinger CS. Lifestyle Factors in Cancer Survivorship: Where We Are and Where We Are Headed. Journal of Personalized Medicine. 2015; 5(3):243-263. https://doi.org/10.3390/jpm5030243

¹¹Ballard-Barbash R, Friedenreich CM, Courneya KS, Siddiqi SM, McTiernan A, Alfano CM. Physical activity, biomarkers, and disease outcomes in cancer survivors: a systematic review. Journal of the National Cancer Institute. 2012 Jun 6;104(11):815-40.

¹²Pierce JP, Stefanick ML, Flatt SW, Natarajan L, Sternfeld B, Madlensky L, Al-Delaimy WK, Thomson CA, Kealey S, Hajek R, Parker BA. Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity. Journal of Clinical Oncology. 2007 Jun 6;25(17):2345.

¹³Andreas S, Rittmeyer A, Hinterthaner M, Huber RM. Smoking cessation in lung cancer—achievable and effective. Deutsches Ärzteblatt International. 2013 Oct;110(43):719.

¹⁴Kroenke CH, Kubzansky LD, Schernhammer ES, Holmes MD, Kawachi I. Social networks, social support, and survival after breast cancer diagnosis. Journal of Clinical Oncology. 2006 Mar 1;24(7):1105-11.

¹⁵Phillips F, Jones BL. Understanding the lived experience of Latino adolescent and young adult survivors of childhood cancer. Journal of Cancer Survivorship. 2014 Mar;8:39-48.

¹⁶Yi J, Kim MA, Akter J. How do they grow out of their cancer experience? Korean adolescent and young adult cancer survivors’ stories. Ethnicity & Health. 2021 Nov 17;26(8):1163-79.

¹⁷Head KJ, Iannarino NT. “It changed our outlook on how we want to live”: Cancer as a transformative health experience for young adult survivors and their family members. Qualitative Health Research. 2019 Feb;29(3):404-17.

¹⁸Mao JJ, Palmer CS, Healy KE, Desai K, Amsterdam J. Complementary and alternative medicine use among cancer survivors: a population-based study. Journal of Cancer Survivorship. 2011 Mar;5:8-17.

¹⁹O’Regan, B. (1995). Spontaneous remission: An annotated bibliography. Petaluma, CA: Institute of Noetic Sciences

²⁰Turner KA. Spontaneous/radical remission of cancer: Transpersonal results from a grounded theory study. International Journal of Transpersonal Studies. 2014;33(1):7.