From Surviving to Thriving: How Primary Care Can Support Life After Breast Cancer

It was a warm, breathless morning when I was led into a stark, windowless room at Melbourne International Airport. The fluorescent lights hummed overhead, casting a harsh glow across bare walls that smelled faintly of disinfectant. I perched on a hard plastic chair, its edges biting into my skin, while a security officer asked me to strip from the waist up.

She pointed at my blouse. “We need to check those. They could be explosives.”

For a moment, the air went still. Heat surged through me; tears blurred my vision.

“Is it over?” I whispered, the words breaking under the weight of my tears. My voice carried not anger, but exhaustion and confusion. Why, after everything, did my body still feel like a battlefield?

It had been five years since finishing gruelling treatment for stage three breast cancer. Yet here I was, still unravelling in moments like this. Why was it all still so hard?

I stepped back into the terminal and was immediately swallowed by a sea of people. The air was heavy with coffee and jet fuel, the clatter of rolling suitcases and the sing-song of boarding calls blurring into a low, constant hum. I felt myself vanish in the crowd.

Instinctively, I reached for my phone to message another young survivor—but my hand froze midair. Of the women I’d sat beside in chemo chairs, I was the only one still alive. A wave of survivor’s guilt pressed down on me, quick and suffocating. In my attempt to “move on,” I had drifted away from most of my breast cancer support groups. Now the silence of that choice echoed back at me. The loneliness was crushing.

When I turned to my general practitioner (GP) and oncologist, they reminded me—gently—that I was lucky to be alive. I was cancer-free. I no longer needed a walking frame. Perhaps, they suggested, therapy would help. Their words kept me afloat, but I was still adrift. The care that had saved me was no longer enough; it wasn’t helping me find a way to live. And as a GP myself, I understood why.

Our healthcare system excels at treating disease, at pulling people back from the brink. But once the crisis is over, survivors like me are often left to navigate the silence alone.

The hardest parts of survivorship are rarely visible: the anxiety that shadows each follow-up, the debt and job insecurity left in cancer’s wake, the strain on intimacy and identity, the silence of lost community, and the maze of a health system that at times offers little guidance (Jefford et al., 2022; Nekhlyudov et al., 2019). None of it fits neatly into a prescription pad or a follow-up scan.

Searching for answers, I turned to the research literature but found only gaps. Cancer is increasingly a chronic condition, yet survivorship research has not kept pace (Gallicchio et al., 2021). We measure survival in years, but rarely in quality. And it is often the non-medical needs — connection, belonging, meaning — that determine whether we truly thrive (Khajoei et al., 2024; Thompson et al., 2025).

Ultimately, I turned to my peers, joining a local dragon boating team for breast cancer survivors. Time on the water was healing. The rhythm of paddling eased my isolation, the exercise helped my lymphoedema, and the laughter rebuilt my confidence.

My story, painful as it felt in that airport, is echoed in the lives of millions of others. Each year, more than 2.3 million women are diagnosed with breast cancer worldwide (Kim et al., 2025). In the UK, around 76% now survive ten years or more after diagnosis (Barclay et al., 2024).

But survivorship is far from simple. Many continue to live with lasting physical, emotional, and social challenges — the kinds of needs that fall outside traditional medical care (Jefford et al., 2022).

Looking back, it was through these experiences that the idea for my DPhil project began to take shape. It grew from a question that often surfaced in the quiet hours of reflection: how can GPs better support people living with and beyond breast cancer?

I also wondered whether social prescribing — connecting patients with community-based activities and supports — might offer part of the answer. Could approaches like exercise groups, peer networks, or creative programmes help other survivors not only recover, but truly thrive?

Emerging evidence, and the lived experiences of survivors themselves, suggest that it can (Ramirez et al., 2020). Initiatives such as dragon boating teams, walking groups, and arts-based programmes do more than fill time; they help rebuild confidence, foster belonging, and restore a sense of meaning and control (Duffin, 2016).

My DPhil project takes a realist approach to explore this further — asking what works, for whom, and in what circumstances. Rather than seeking a single solution, it aims to understand how and why (or why not) social prescribing might make a difference within the complex realities of cancer survivorship.

As a first step, I conducted a scoping review of the existing evidence, now in the process of publication. We identified 67 studies from 13 countries. The most common interventions included exercise programmes, arts-based activities, peer support, and information or advice services. These were typically designed to enhance emotional wellbeing, physical function, and social connectedness.

The findings were encouraging. Many studies reported improvements in wellbeing, quality of life, and social participation. Yet the limitations were striking: most evaluations were short-term, inconsistent, and concentrated in high-income settings. Few considered cultural diversity or long-term survivorship. While oncology nurses often played central roles, the contribution of general practice was rarely explored — revealing a critical gap in understanding how GPs can support life beyond cancer.

In short, social prescribing shows genuine promise as a bridge between clinical care and community life (Drinkwater et al., 2019). To realise that potential, we need more robust and inclusive models of care — and clearer guidance for GPs on how to integrate social prescribing into everyday practice.

For me, this work is deeply personal. It represents a way of giving back — to the women I paddled alongside, and to those no longer here. Survivors deserve more than survival; they deserve to thrive. Primary care has the potential to be that bridge between surviving and truly living.

My hope is that, through research and collaboration, thriving after breast cancer can become a reality for all women. Because life after cancer is not simply about counting the years we survive — it is about ensuring those years truly count.

Katherine is currently studying on the DPhil for Evidence-Based Health Care.  You can find out more information and how to apply by visiting the programme page and in these videos on our YouTube Channel.

References

• Barclay, N. L., Burn, E., Delmestri, A., Duarte-Salles, T., Golozar, A., Man, W. Y., Tan, E. H., Tietzova, I., & Prieto-Alhambra, D. (2024). Trends in incidence, prevalence, and survival of breast cancer in the United Kingdom from 2000 to 2021. Scientific Reports, 14(1), 19069.
• Drinkwater, C., Wildman, J., & Moffatt, S. (2019). Social prescribing. BMJ, 364, l1285. https://doi.org/10.1136/bmj.l1285
• Duffin, C. (2016). Assessing the benefits of social prescribing. Cancer Nursing Practice, 15(2).
• Gallicchio, L., Tonorezos, E., de Moor, J. S., Elena, J., Farrell, M., Green, P., Mitchell, S. A., Mollica, M. A., Perna, F., & Saiontz, N. G. (2021). Evidence gaps in cancer survivorship care: A report from the 2019 National Cancer Institute Cancer Survivorship Workshop. JNCI: Journal of the National Cancer Institute, 113(9), 1136–1142.
• Jefford, M., Howell, D., Li, Q. P., Lisy, K., Maher, J., Alfano, C. M., Rynderman, M., & Emery, J. (2022). Improved models of care for cancer survivors. The Lancet, 399(10334), 1551–1560.
• Khajoei, R., Azadeh, P., ZohariAnboohi, S., Ilkhani, M., & Nabavi, F. H. (2024). Breast cancer survivorship needs: A qualitative study. BMC Cancer, 24(1), 96. https://doi.org/10.1186/s12885-024-11834-5
• Kim, J., Harper, A., McCormack, V., Sung, H., Houssami, N., Morgan, E., Mutebi, M., Garvey, G., Soerjomataram, I., & Fidler-Benaoudia, M. M. (2025). Global patterns and trends in breast cancer incidence and mortality across 185 countries. Nature Medicine, 31(4), 1154–1162. https://doi.org/10.1038/s41591-025-03502-3
• Nekhlyudov, L., Mollica, M. A., Jacobsen, P. B., Mayer, D. K., Shulman, L. N., & Geiger, A. M. (2019). Developing a quality of cancer survivorship care framework: Implications for clinical care, research, and policy. JNCI: Journal of the National Cancer Institute, 111(11), 1120–1130. https://doi.org/10.1093/jnci/djz089
• Ramirez, A. G., Choi, B. Y., Munoz, E., Perez, A., Gallion, K. J., Moreno, P. I., & Penedo, F. J. (2020). Assessing the effect of patient navigator assistance for psychosocial support services on health-related quality of life in a randomised clinical trial in Latino breast, prostate, and colorectal cancer survivors. Cancer, 126(5), 1112–1123. https://doi.org/10.1002/cncr.32626
• Thompson, T., Doherty, M., Berrett-Abebe, J., Brown, C., Hallgren, E., Kirk, S., Weal, R., Chauhan, K., & Cadet, T. J. (2025). Social needs in cancer survivors: A scoping review and future directions. Current Oncology Reports, 27, 717–733. https://doi.org/10.1007/s11912-025-01664-4