Remission Isn’t Recovery: Why the Fifth Phase of Cancer Is Missing from Our System

Aug 5

Written By

By Cindy Finch, LCSW

“There’s nothing quite like planning a funeral while picking up your kid from preschool.”

I was diagnosed with cancer after giving birth to my third child. The tumor had grown especially large thanks to my body's hormones that had been growing my baby. The medical community helped my disease—but could not help my despair.

Then, five years after cancer—and just after I finished my first triathlon—I developed heart, liver, and lung failure. My body had been overtaken by the long-term damage of earlier cancer treatments. I vividly remember sitting in my oncologist’s office after nights without sleep, with wild mood swings, profuse sweating, and panic attacks. He looked at me and said, “Well, at least we saved your life.” As if that was all I could hope for.

You're alive. Be happy. Now go away.

But who would save my mind?

The medical community had no answers and little care for the trauma I was carrying. And I wasn’t alone. Today, one in every 20 adults in the U.S. is a cancer survivor. While we’ve gotten better at treating tumors, we’ve neglected what happens next: the human aftermath.

This is what I call the Fifth Phase of Cancer—and it’s time we make it standard.

The Five Phases of Cancer (What They Don’t Teach You in Med School)

Diagnosis – What is this lump?
Treatment – Kill it before it kills me.
Survivorship – Ring the bell, then go home.
Aftershock – Scanxiety, trauma, silence.
Recovery – Time to reclaim my life, body, and mind.

Right now, we stop care at #3. But true healing requires all five.

What Survivors Face After the Bell Rings

When cancer treatment ends, patients are often at their lowest. The structure is gone. The caretakers disappear. And the body is often left in wreckage—chronic pain, infertility, sleep problems, PTSD, survivor’s guilt, and grief for the life that was.

Friends and family may step back. Work and finances are often shattered. Marriages fall apart. Children act out. The trauma doesn’t end—it starts.

And most therapists? Aren’t trained for this.

One client of mine, a 40-something mom with terminal colorectal cancer, faced a surgery that would remove every female and digestive organ in her body. How could CBT help her with that?

She didn’t need a mindset shift. She needed a witness.

A Survivor Speaks:

“I didn’t want to die. But I didn’t know how to live anymore either.”

We Need to Build the Fifth Phase: A New Standard of Care

In 2007, the Institute of Medicine published Cancer Care for the Whole Patient, urging that psychosocial support be embedded into cancer treatment. But most hospitals never implemented it.

➡ It’s time to make it law.

We must:

Designate a Survivor Specialist on every care team
Train all health professionals in trauma-informed psycho-oncology
Require fifth-phase education to renew licensure
Make psychosocial care reimbursable by insurance
Include classes like those at Reimagine.me for patients and caregivers
Offer books, videos, and peer mentorship from the start of treatment
Involve chaplains, therapists, and spiritual leaders as essential—not optional

If we treat the tumor but not the trauma, we haven’t really healed anyone.

What You Can Do Right Now

If you're a survivor:

Journal, pray, or move your body daily
Tell your story in small doses to people who can hold it
Join a group or find a trauma-informed therapist
Don't isolate. Don’t rush. You’re not behind.

If you're a clinician:

Ask about survivor trauma during follow-ups
Refer out. Learn more. Be human before expert
Advocate for embedded psycho-oncology at your institution

If you love someone with cancer:

Keep showing up after the bell rings
Ask open-ended questions like, “What’s been the hardest part?”
Offer a ride, a meal, or just your quiet presence

And if you’re in charge of anything—school, church, hospital, nonprofit, legislature: 👉 Make trauma care part of cancer care.

Because remission isn’t recovery.

And nobody should have to survive cancer alone.

📚 Further Reading & Resources:

Radical Remission by Kelly A. Turner, PhD
The Body Keeps the Score by Bessel van der Kolk, MD
Stupid Cancer – Advocacy for young adult survivors
Elephants and Tea – AYA cancer survivor stories
Cancer Support Community – National free support
Imerman Angels – Peer-to-peer cancer mentorship
Reimagine.me – Online workshops for meaning-making
Vincible Documentary – Featuring my story and others

About the Author: Cindy Finch, LCSW, is a clinical therapist, writer, and professor who trained at Mayo Clinic. She is a survivor of undiagnosed pregnancy-related cancer that led to heart, liver, and lung failure. Cindy now lives in Orange County, CA with her husband Darin and their three children. Her story is featured in the documentary Vincible. Learn more at [website].

This content is not intended as a substitute for professional medical or mental health advice. If you’re in crisis, please contact your doctor, therapist, or call 911.