Many patients feel the emotional effects of cancer most strongly once treatment has ended (Image: Getty)
Cancer patients in England face sharply uneven access to mental health care after treatment, new charity research suggests. Freedom of Information responses from 81 NHS trusts found that 48% had no formal aftercare pathway including psychological support. A further 15% said they provided no post-treatment support at all, with availability differing significantly by area.
The regional gap was stark: nearly nine in 10 trusts in the South West reported having a formal survivorship pathway, compared with only 20% in the East of England. Breast cancer charity Future Dreams said its own separate research showed 76% of users looked for emotional support more than two years after finishing primary treatment.
Dr Fharat Raja, consultant medical oncologist and trustee of Future Dreams, said that after a cancer diagnosis, many patients are quickly swept into the urgent demands of treatment.
He said there is often little time or space during that period to understand the wider impact on a person’s mental wellbeing, family life, work and future plans.
When treatment comes to an end, he added, many patients are suddenly confronted by a surge of emotions as they begin to absorb what they have experienced.
For some people, Dr Raja said, the expected return to “normal” never fully arrives, making psychological care a vital part of recovery.
Zoe Yessaian, a senior NHS mental health nurse and breast cancer survivor, said she did not begin to confront the emotional consequences of her diagnosis until after her treatment had finished.
She added: “During treatment I was focused on survival. There was always another appointment, another decision and another hurdle to get through.
“It wasn’t until active treatment ended that I really began to process everything that had happened and how much cancer had changed my life.
“Despite working in mental health, I still found the emotional impact of breast cancer incredibly difficult. Cancer had taken away so much of the control I felt I had over my future, which is why support after treatment is so important.
“Recovery doesn’t simply begin and end with the physical side of cancer.”
The Express Cancer Care crusade has highlighted the need for better mental health support for cancer patients since January 2025.
Reporter Robert discovered support was lacking after his diagnosis (Image: Jonathan Buckmaster)
Reporter Robert Fisk spearheaded the campaign after witnessing how too many people were falling through the cracks during his own treatment for stage four bowel cancer.
He exposed how NHS holistic needs assessments — questionnaires that identify a patient’s physical, emotional, social, spiritual, and practical concerns — were not being used consistently.
The campaign led to the announcement in February that every cancer patient will be given a Personalised Cancer Plan to help them cope with the psychological toll, under Labour’s National Cancer Plan.
However, charities have warned that this promise must be fully implemented to be effective.
Macmillan Cancer Support’s chief executive Gemma Peters said in March that potential barriers included staff training and leadership commitment, adding: “Do hospital leaders really see it as being important?”
Future Dreams chief executive Sam Jacobs said: “These findings paint a worrying picture of the support available to cancer patients once treatment ends.
“As the Government develops its National Cancer Plan, survivorship support must become a core part of cancer care rather than something patients have to navigate alone.”
