In oncology, ‘survivorship’ is often framed as something that begins post-treatment – helping individuals manage the long-term physical, emotional, and social effects of cancer as they return to daily life. While these services are essential for helping patients transition after treatment, they are just as valuable during treatment.
Early integration of survivorship services into a patient’s care plan – including core services like symptom and side-effect management, mental health and psychosocial support, nutrition and physical rehabilitation, and navigation assistance for care coordination and insurance – can help ease the burdens of cancer care, improve a patient’s quality of life and strengthen their ability to remain engaged throughout the treatment journey. At its core, survivorship care is rooted in a whole-person health approach – bringing together medical, psychosocial, and practical support to help patients live well during treatment and long after it ends.
Reframing Survivorship to Start at Diagnosis
While survivorship care is recognized as an essential part of the cancer care journey, clinical guidelines around it remain largely underdeveloped and are rarely offered immediately following a diagnosis. In a landscape assessment of cancer programs across the US, only 43% reported including survivorship care plans, with the vast majority focused only on survivors of cancer who were likely to remain in remission for multiple years. Similarly, while Europe’s Beating Cancer Plan does include an explicit focus on the “quality of life of cancer patients and survivors”, advocates argue that survivorship care guidelines are weakly implemented across EU healthcare contexts and remains treated as an “add on” service, rather than a core part of cancer care.
Based on the perspective of Dr. Lawrence Mendelson, who notes “Every cancer patient is considered a cancer survivor from the very first moment of their initial diagnosis”, the existing approach to survivorship is too narrow and highly fragmented.
The moment of a cancer diagnosis is often when patients need the most support, as the emotional, physical, and logistical demands of care begin to surface all at once. These challenges are even greater for patients from marginalized or underserved communities, who disproportionately experience care delays and higher rates of late-stage diagnosis – complicating their care journey – as well as limited navigation literacy and financial or logistical barriers to initiating care. Embedding survivorship from the moment of diagnosis offers an opportunity to make cancer care more manageable, equitable and patient-centered.
Systemic Barriers Hinder Early Survivorship Care
However, several systemic barriers inhibit early delivery of survivorship services. Providers face growing time and resource constraints, particularly in community and rural settings where workforce shortages and limited specialist availability make it difficult to provide nonclinical services. More than half of community oncology providers reported insufficient staffing for navigation and psychosocial services during active treatment.
Expenses and reimbursement challenges compound these gaps. Many navigation and survivorship programs rely on short-term grant funding or philanthropy to sustain operations. Government leaders across the EU acknowledge that the lack of sustainable funding or reimbursement models inhibit their ability to standardize and scale cancer navigation services across the health system. Similarly, a 2025 analysis found that the lack of consistent reimbursement has historically limited the scalability of navigation services acrss the U.S. health system, and new Principal Illness Navigation (PIN) codes have only recently been introduced to offset operational costs.
Furthermore, despite growing recognition of its value, survivorship remains siloed to post-treatment care, with limited coordination between medical, psychosocial, and practical support service teams. To deliver survivorship early, cancer care systems need more than intent – they need the right infrastructure and people within the care team to ensure patients receive the support they need at every step of their care journey.
Leverage the Power of Allied Health Professionals
Allied health professionals (AHPs) are the quiet backbone of cancer care – providing cost-effective, personalized support that patients rely on throughout their treatment journey. In oncology, AHP care teams can include nurse navigators, oncology social workers, dietitians, rehabilitation therapists, mental health counselors, and community health workers.
By providing education, coordinating referrals, addressing social and financial needs, and supporting patients through the emotional and logistical challenges of cancer treatment, early engagement of AHPs has shown to:
- strengthen patient engagement in care
- improve adherence to treatment plans, especially among low-income patients who greatly benefit from referrals to social and financial support services to mitigate access barriers
- streamline management of symptoms and side-effects – reducing emergency department visits and hospitalizations
- enhance coordination of follow-up care
- improve overall treatment outcomes
Yet even with clear evidence of their value, access to AHPs remains fragmented and inconsistent – shaped by reimbursement limitations, workforce shortages, and variation in prioritization of supportive care.
Leveraging the success of AHPs in HIV
Across the HIV care continuum, allied health professionals (AHPs) have long played a central role in helping people get connected to HIV care, stay engaged, and overcome barriers to HIV treatment. Through navigation support, psychosocial counseling, education, and referrals to essential services like housing or transportation, AHPs have helped make whole-person, coordinated care the norm in HIV.
A national evaluation of publicly funded navigation programs across five states found that the use of patient navigators with backgrounds in nursing, social work, or community health significantly improved outcomes for people who were newly diagnosed with HIV, had never entered HIV care, or had fallen out of HIV care and treatment. All navigator programs reported increases in the proportion of patients achieving viral suppression over 12 months, underscoring how sustained, community-rooted support can address the social and emotional factors that shape long-term engagement in care.
This model has proven effective for decades—and offers a powerful blueprint for expanding AHP-led, whole-person support across complex care disease pathways, including cancer care during treatment and long there-after.
Pathways to integrating AHPs in survivorship care
Bridging the gap in survivorship care is dependent on building the AHP workforce and will require intentional action across policy, reimbursement, and healthcare practice. Some potential approaches to consider:
AHPs as a key part of multidisciplinary oncology care
Advocacy remains one of the most powerful catalysts for driving meaningful change across the healthcare system. Strengthening the AHP workforce must be a central priority in advancing survivorship for whole-person cancer care, but building the workforce alone is not enough –AHPs must also be fully integrated into multidisciplinary oncology care teams as a core component of quality care. Advocacy efforts should pair powerful patient and caregiver stories with strong economic and evidence-based data showing how AHPs streamline navigation, enhance engagement, improve adherence, and reduce avoidable healthcare utilization.
Investing in our nurses
In many countries, both within the U.S. and across countries in the EU, nurses have taken on the role of providing allied health and navigation services to patients newly diagnosed with cancer. However, the global nursing shortage has led to significant variability in the delivery of these services and overburdened nurses that are already struggling with capacity constraints. To build a sustainable and resilient healthcare model, health systems will need to either 1) grow a dedicated workforce of AHPs that can support and fill the capacity gaps of oncology nurses or 2) meaningfully invest in strengthening the nursing workforce itself. Effective strategies for strengthening the nurse workforce include loan-forgiveness programs, which was recently removed in the U.S., retention and upskilling incentives, competitive salary adjustments tied to oncology competencies or equipping nurses with dedicated AI tools to streamline their workload.
Expanding role of medical liaisons
Industry partners can also help mitigate workforce shortages by expanding the role and capabilities of their medical liaisons. Traditionally focused on educating providers about new treatments, medical liaisons are uniquely positioned to also support patients – helping them better understand their treatment options, navigate complex care decisions, and advocate for the therapies best aligned with their needs. By equipping medical liaisons with training in patient education, health literacy, and care navigation, companies can extend critical support into communities where AHPs are scarce.
Leveraging successful models of care
Scaling successful care models like the Oncology Medical Home (OMH) can provide an opportunity to strengthen coordination between AHPs and clinical providers. The OMH model creates a centralized system of care in which the oncology practice serves as the patient’s “medical home”. AHPs are built into the OMH team, alongside oncologists and other clinical providers. OMH practices have demonstrated improvements in patient experience, reduced emergency visits and hospitalizations, improved care coordination and proactive symptom triage. Scaling OMH principles across the system through reimbursement incentives and quality standards can help expand access to AHPs and bring a whole-person-health approach to more oncology settings nationwide.
Integrating AHPs into public insurance
In 2024, more than 2 million Americans were projected to be diagnosed with cancer, and over 1 million of them – those age 65 and older – will rely on Medicare for coverage, while 1 in 10 adults with a history of cancer depend on Medicaid. These public insurance programs are therefore both lifelines for patients and critical levers for strengthening the cancer care system. By embedding AHPs into Medicare and Medicaid reimbursement structures, policymakers can support earlier intervention, improve navigation and adherence, and ultimately reduce long-term costs associated with avoidable complications, emergency visits, and fragmented care.
Supporting community and patient organizations to bridge access
Patient advocacy groups (PAGs) remain some of the most trusted and accessible resources for people navigating cancer across the U.S., often filling critical gaps in survivorship support through peer-to-peer networks, navigation hotlines, patient education, and community-based programs. As the healthcare system works toward integrating AHPs as a standard part of oncology care, it is essential that multi-sector funders continue to invest in these organizations to ensure they can continue to serve as powerful partners in delivering whole-person, equitable survivorship care, especially for those that may experience high medical mistrust.
AHPs offer a proven pathway to delivering whole-person survivorship care from day one. Strengthening and integrating this workforce globally will help ensure that every patient – regardless of where they’re treated – has access to coordinated, compassionate support throughout their cancer journey.