Following a cancer treatment plan can be physically, emotionally, and practically challenging, and many patients struggle at times to stay fully engaged with care.
People often look to five-year cancer survival rates, yet these statistics are frequently misunderstood and do not account for the complexity of individual experiences during treatment.
This article explores what cancer survival rates can and cannot tell you, why staying engaged and communicating openly with your care team matters, and how psychological and situational barriers can affect a person’s ability to follow a treatment plan.
What Five-Year Cancer Survival Rates Can (and Cannot) Tell You
In my work as a clinical psychologist, conversations about five-year cancer survival rates have been important with many cancer patients. These statistics often carry significant emotional weight, and they are easy to misunderstand.
The stories that follow are amalgamations of actual client experiences. Identifying details have been altered to protect privacy.
I worked with Mario, a 50-year-old entrepreneur who had been diagnosed with stage-three colon cancer. The published five-year survival rate associated with his diagnosis was 76 percent.
Like many patients, Marco wanted to understand what that number meant for him personally. Survival statistics are based on large groups of people, not individuals. They reflect averages drawn from populations that vary widely in age, overall health, access to care, and ability to tolerate treatment.
These statistics also include people who decline treatment, people who begin treatment but are unable to continue, and people whose health or life circumstances make full participation in care very difficult. For this reason, population-level survival rates cannot predict what will happen to any one person.
Why your individual situation may differ from the average
This does not mean that outcomes are fully within a patient’s control. Many factors that influence survival cannot be changed. However, staying engaged with medical care and communicating openly with one’s treatment team can matter.
By “engaged,” I do not mean perfect adherence. Cancer treatment is physically and emotionally demanding, and most patients encounter periods when following recommendations becomes difficult or temporarily impossible.
Why Staying Engaged With Treatment Matters
What matters most is staying in communication with your doctors when things become hard.
Some patients say they are doing everything they have been asked to do even when they are struggling. This is rarely about dishonesty. More often, it reflects fear, exhaustion, shame, or a desire not to disappoint people they depend on.
Why people may underreport difficulties to their doctors
I know this from experience. When I worked with patients managing diabetes, I would often ask whether they were monitoring their blood glucose levels as recommended. Most would say yes. When I changed the question and asked how many times a week they were unable to measure their blood glucose as prescribed, many acknowledged that they were struggling more than they initially let on.
Doctors expect this. They know that treatment plans are difficult and that setbacks are part of the process. They can only help, however, if they know what is actually happening.
What to Do When You Cannot Follow the Plan as Intended
When patients tell their doctors that they cannot tolerate side effects, cannot exercise as recommended, or are unable to keep medications down, medical teams can often adjust treatment, offer alternatives, or provide additional support. Sometimes the solution is relatively simple. Sometimes it requires patience and trial-and-error.
What is most unhelpful is going silent.
A Story About Relapse, Avoidance, and Not Going Silent
When I was completing my residency as a newly minted clinical psychologist, I became friends with Eliza, a woman who worked in the same hospital department.
Eliza was diagnosed with stage-one breast cancer. She had surgery and was given the option of chemotherapy, which she declined after careful consideration.
She was then prescribed Tamoxifen to reduce the risk of recurrence. Her doctors advised her not to smoke while taking the medication, as smoking could interfere with its effectiveness.
Eliza had been a smoker for many years. Initially, she stopped smoking and took the medication as prescribed. Over time, she struggled with her addiction and began smoking again. Rather than asking for help or discussing this with her medical team, she stopped taking the medication altogether.
Relapse is common under stress
I do not know what support Eliza sought or what she felt able to share at the time. What I do know is that relapse, ambivalence, and avoidance are common human responses under stress. Medical teams expect these difficulties and are often better positioned to help when patients speak openly about them.
Fear can make people withdraw. Silence is often a sign of distress, not indifference.
Considering Next Steps
If you are in cancer treatment and you are struggling to follow recommendations exactly as intended, tell your medical team what is happening. You do not need to have a perfect plan before you speak up. Many obstacles can be addressed once they are on the table.
If fear, overwhelm, shame, or exhaustion is making it hard to stay engaged, consider reaching for additional support. A psychologist can help you manage the emotional load of treatment, reduce avoidance, and find practical ways to stay connected to your care, even when things feel unmanageable.
No one expects cancer treatment to be easy. Outcomes are never guaranteed. But staying connected, asking for help when obstacles arise, and being honest about what you can and cannot do can support you in navigating treatment as effectively as possible.
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