The Importance of Survivorship and Supportive Care Research: Interviews with Drs. Peterson and Tippey

06/22/2026

Written by David Timm, MSc, CCRP, NRG Patient Advocate Committee Member, Washington University in St. Louis

Nothing can prepare you for a cancer diagnosis in your family. I had worked in oncology research for several years, spending time with patients and their families nearly every workday. I thought that if this ever happened to one of us, we’d be prepared. But when my husband was diagnosed with Acute Lymphoblastic Leukemia, it was a flurry of emotions, information, appointments, etc. Suddenly, I was seeing things from the other side, realizing just how overwhelming it truly is for patients and their loved ones.

As my husband went through his treatment, moved on to maintenance, and eventually entered a surveillance phase, I realized something important as I reflected on all the experiences he went through. His care team did an amazing job treating the disease itself, but what about the other aspects of life that become dysregulated by a diagnosis? The body becomes weaker. The mind battles extreme emotions and anxiety. There are side effects, social isolation to avoid getting sick (especially since we were going through the COVID-19 pandemic during this time), and dreams are put on hold. That’s not to mention the staggering cost of healthcare and the resulting financial burden.

I realized during this entire ordeal that so much of what we are doing is treating the disease but not always treating the person. I wanted to change that. While working in oncology, I began promoting survivorship and supportive care research. If I saw a study that we could open, I brought it to the relevant parties. I joined advocacy organizations, networked, and tried to bring interested folks together. A couple of years later, we now have a survivorship workgroup dedicated to research and care policies in this area. Seeing familiar faces on our Zoom calls is incredibly exciting, and I hope to be part of making a real difference for patients. 

How do you transition back to a “regular life” once the treatment is done? In honor of Cancer Survivorship Month, I wanted to delve into how patients can survive and thrive during and after the cancer treatments are over.

Interview with Dr. Peterson:
Dr. Lindsay Peterson is a breast cancer specialist and Director of the Survivorship Program here at Siteman Cancer Center (SCC) and is one of those dedicated individuals. She has been the lead investigator on several supportive care trials and recently opened an acute survivorship clinic. I wanted to ask her a few questions to share her insights from a medical oncologist’s perspective.

Can you share a little about your background, the breast cancer survivorship clinic you currently run, and what initially drew you to focus on survivorship outcomes?

I completed my oncology training in San Antonio, Texas, where I had the opportunity to work with a mentor who emphasized caring for the whole patient, not just treating the cancer itself. That experience had a profound impact on me early in my career. I saw firsthand how important it was to address the physical, emotional, and practical challenges patients face during and after treatment, and how much those issues influence quality of life and overall well-being.

As I began building my own practice, that philosophy naturally became a central focus of my work. Over time, I became increasingly interested in survivorship outcomes and in developing better ways to support patients throughout their cancer journey, not only after treatment ends, but beginning at diagnosis and continuing long term.

Currently, I direct our survivorship program and run a cancer survivorship clinic, the START Strong clinic, that was designed to integrate survivorship care much earlier in the patient experience. Through this clinic, we focus on issues such as symptom management, physical activity, nutrition, emotional health, treatment-related side effects, and helping patients feel informed and empowered during a very overwhelming time. One of the most rewarding parts of this work has been seeing how meaningful these interventions can be for patients and recognizing that survivorship care truly has the potential to improve both quality of life and cancer outcomes.

What does your day-to-day work in cancer survivorship look like?

My day-to-day work in cancer survivorship is quite varied, which is one of the things I enjoy most about it. A significant part of my time is spent seeing patients, either in our survivorship clinic or in my own breast oncology clinic, where I try to incorporate the same survivorship principles into every visit. Even during active treatment, I believe it is important to address not only the cancer itself, but also symptoms, emotional well-being, lifestyle factors, long-term health, and the practical challenges patients and families face.

In our survivorship clinic, we spend dedicated time focusing on areas such as physical activity, nutrition, symptom management, treatment-related side effects, emotional health, and helping patients feel more informed and empowered throughout their cancer journey. While the clinic was initially designed to see patients early in treatment, we have found that patients benefit at many different time points, as each stage of survivorship presents unique needs and opportunities for intervention and support.

Outside of direct patient care, a large portion of my work involves continuing to expand and strengthen our survivorship program and supportive care offerings. This includes developing new clinical models, building collaborations across disciplines, and finding ways to better integrate survivorship care into routine oncology practice.

I also spend time working on research projects, clinical trials, and grants related to breast cancer and survivorship. Much of this work focuses on lifestyle interventions, symptom management, patient-reported outcomes, and strategies to improve both quality of life and long-term health outcomes for cancer survivors. One of the most exciting aspects of this field is that there is still tremendous opportunity to innovate and help move survivorship care forward in meaningful ways.

Why is focusing on survivorship so critical for a patient’s overall quality of life and future prevention?

Focusing on survivorship is critical because cancer care does not end when treatment is completed. For many patients, particularly those with breast cancer, survivorship care has a major impact not only on quality of life, but also on long-term health outcomes and even cancer prognosis.

We now have growing evidence showing that patients who more closely follow survivorship guidelines—particularly around physical activity, nutrition, weight management, and other healthy lifestyle behaviors, often experience better long-term outcomes. These interventions can improve fatigue, physical functioning, emotional well-being, and overall quality of life, but studies also suggest they may reduce the risk of cancer recurrence and cancer-related death in some populations.

Another important aspect of survivorship care is the recognition and management of symptoms and patient-reported outcomes, or PROs. Research has demonstrated that systematically monitoring and addressing symptoms such as pain, fatigue, anxiety, depression, and treatment side effects can not only improve how patients feel but may also improve cancer outcomes and survival. When we proactively identify problems early, we are often able to intervene sooner, keep patients healthier and more engaged in their care, and help them tolerate and complete treatment more successfully.

I also think survivorship care is empowering for patients. A cancer diagnosis can leave people feeling as though so much is outside of their control, but survivorship care helps patients recognize that there are meaningful steps they can take to support their health and well-being moving forward. That sense of education, support, and empowerment can be incredibly important during and after cancer treatment.

When developing a plan and putting in referrals for the patients coming into this clinic, what are the most essential elements of survivorship care, and how do you approach these conversations with your patients?

When developing a survivorship plan for patients, some of the most essential elements we focus on are nutrition, physical activity, weight management, symptom management, and emotional well-being. These areas are closely connected, not only to overall health and quality of life, but also to long-term cancer outcomes.

One of the most important parts of my approach is that the conversation is highly individualized. Rather than simply giving patients a list of recommendations, I try to understand what symptoms or concerns are most affecting them personally. For one patient, that may be fatigue or loss of strength. For another, it may be anxiety, sleep issues, weight changes, neuropathy, or difficulty returning to normal life after treatment. Framing survivorship interventions around the specific challenges a patient is experiencing often make the recommendations feel more relevant, achievable, and meaningful.

For example, we talk about how physical activity can help improve fatigue, mood, sleep, strength, and treatment tolerance, while also being associated with improved cancer outcomes in many studies. Similarly, discussions around nutrition and weight management are not only about long-term health and prevention, but also about helping patients feel better day to day and reducing future health risks. We try to help patients make sustainable lifestyle changes rather than aiming for perfection.

A major goal of these visits is helping patients feel supported and empowered rather than overwhelmed. Cancer treatment can leave many patients feeling that they have lost control over their bodies and health. Survivorship care provides an opportunity to help patients recognize that there are evidence-based steps they can take to improve both their quality of life and potentially their long-term outcomes moving forward.

How is survivorship currently being studied in clinical trials? Could you share some of your past work in this area and what you’d ideally like to see moving forward? 

Survivorship is being studied in clinical trials in a number of different ways, and I think the field has evolved tremendously over the last decade. Some trials are dedicated entirely to survivorship questions, focusing on areas such as physical activity, nutrition, symptom management, emotional health, cognitive function, sexual health, or other quality-of-life concerns. In other cases, we incorporate survivorship endpoints into traditional treatment trials so that we are not only evaluating how well a therapy treats the cancer, but also how patients feel and function during and after treatment.

I think this is incredibly important because improving outcomes in oncology should not only mean helping patients live longer but also helping them live better. Many of us in survivorship research are interested in interventions that can improve quality of life, reduce symptoms, and potentially improve cancer outcomes, ideally without adding significant toxicity or burden to patients. Positive outcomes without additional toxicity is always the goal.

One of the things I enjoy most about survivorship research is that these are often studies patients are genuinely excited to participate in because they feel relevant to their everyday lives and well-being. Some of my favorite studies have involved yoga and other physical activity interventions during chemotherapy treatment. These studies explored ways to help patients manage fatigue, stress, physical functioning, and treatment-related symptoms while remaining active during a very challenging period of their lives.

I have also been involved in dietary intervention research focused on helping cancer survivors adopt healthier eating patterns and improve biomarkers that may be associated with cancer recurrence and long-term health outcomes. This area is particularly exciting because lifestyle interventions have the potential to influence not only quality of life, but also cardiometabolic health and possibly cancer-related outcomes as well.

Looking forward, I would love to see survivorship become more fully integrated into mainstream oncology research and care delivery. Historically, survivorship has sometimes been viewed as separate from cancer treatment, but in reality it should be woven throughout the entire cancer journey. I also hope we continue expanding research on personalized survivorship interventions, patient-reported outcomes, digital and remote care models, and strategies that make evidence-based survivorship care more accessible to all patients, regardless of where they live or receive treatment.

I’ve noticed a lack of trials purely focused on survivorship and supportive care on sites like clinicaltrials.gov, and many existing studies seem small or limited to a single clinic. What challenges have you encountered in this field, and why do you think this gap exists?

I think that observation is absolutely true, and it highlights one of the major challenges in survivorship research today. Compared with treatment-focused oncology trials, survivorship and supportive care studies are still relatively underrepresented, particularly large multicenter studies.

One of the biggest reasons for this is funding. Treatment trials often have substantial support from pharmaceutical companies because they are evaluating new drugs or therapies that may eventually become commercially available. In contrast, many survivorship interventions—such as exercise, nutrition counseling, yoga, symptom management strategies, or supportive care models do not have the same type of industry funding behind them. As a result, survivorship researchers rely much more heavily on federal grants, foundation support, or institutional resources, which are often limited and highly competitive.

Another challenge is that when institutions have finite research infrastructure and staffing resources, priority is frequently given to treatment trials. Treatment studies are understandably viewed as essential because they may directly influence cancer control and survival, but survivorship research can sometimes be perceived as secondary, despite the fact that it has enormous implications for patients’ quality of life, long-term health, and increasingly, cancer outcomes themselves.

There are also logistical challenges unique to survivorship research. Lifestyle and behavioral interventions can be more difficult to standardize than medications, and adherence can vary over time. Many survivorship studies require long follow-up periods and significant patient engagement, which can make them resource intensive. In addition, quality-of-life and patient-reported outcomes are sometimes viewed as “softer” endpoints compared with traditional oncologic endpoints, even though studies have shown these outcomes are deeply meaningful to patients and may even correlate with survival.

That said, I do think the field is gaining momentum. There is growing recognition that survivorship care is not separate from high-quality cancer care , rather an essential part of it. We are also seeing increasing interest in interventions that can improve outcomes without adding toxicity, particularly around exercise, nutrition, symptom monitoring, and supportive care delivery models. My hope is that over time we will see larger collaborative survivorship trials, greater integration of survivorship endpoints into oncology studies, and more investment in research that helps patients not only survive cancer, but live well afterward.

Are there any local, national, or international programs you’d recommend for patients, caregivers, or advocates who want to learn more about the role of survivorship in their care?

There are several excellent resources available for patients, caregivers, and advocates who want to learn more about survivorship and supportive care. I often encourage patients to seek out information from reputable organizations that provide evidence-based guidance and practical resources focused not only on cancer treatment, but also on life during and after cancer.

Some of the organizations and programs I commonly recommend include:

• Cancer Support Community— Offers education, support groups, emotional support resources, survivorship information, and community programs for patients and caregivers.
• American Cancer Society— Provides extensive survivorship resources related to nutrition, physical activity, long-term side effects, emotional health, screening recommendations, and caregiving support.
• National Cancer Institute Office of Cancer Survivorship— A valuable resource for understanding the science of survivorship, ongoing research, symptom management, and evidence-based survivorship care.

I also encourage patients to speak with their oncology team about local survivorship resources available within their own cancer center or community. Many centers now offer supportive services such as nutrition counseling, exercise programs, mental health support, integrative oncology services, survivorship clinics, and patient education programs that can make a meaningful difference during and after treatment.

One of the most important things for patients to understand is that survivorship care is not just about monitoring for recurrence. It is about helping people live as well as possible physically, emotionally, and socially throughout and beyond their cancer journey.

Thank you so much for taking the time to answer my questions; I’ve really enjoyed learning more about your clinic and the trial side of things. Looking ahead, in an ideal world, where would you like to see our cancer center in the next 5 to 10 years regarding survivorship? 

In an ideal world, over the next 5 to 10 years I would love to see survivorship fully integrated into routine cancer care and viewed as an essential component of oncology, rather than something separate or optional. My hope is that survivorship interventions are valued with the same level of importance as cancer drugs and other treatment advances because they also have the potential to meaningfully improve patient outcomes.

We now have growing evidence that areas such as physical activity, nutrition, symptom management, and patient-reported outcomes can influence not only quality of life, but potentially treatment tolerance, recurrence risk, and survival as well. I would like to see these evidence-based interventions routinely incorporated into standard oncology care pathways for all patients, beginning early in the cancer journey rather than waiting until treatment is over.

From a research perspective, I would also love to see greater investment in survivorship science. There is still so much we need to learn about how to optimize long-term health, reduce treatment-related toxicity, personalize supportive care, and help patients live well after cancer. Ideally, survivorship research would receive the same level of attention, collaboration, infrastructure, and funding support that traditional treatment trials receive today.

Most importantly, I hope we continue moving toward a model of cancer care that recognizes success not only as helping patients survive cancer but helping them truly live well during and after treatment.

Is there anything else you’d like to add on this topic? 

One thing I would add is that survivorship care is ultimately about helping patients feel seen and supported as whole people, not simply as a diagnosis or treatment plan. Cancer affects nearly every aspect of a person’s life, physical health, emotional well-being, relationships, work, identity, and future goals, and survivorship care recognizes and addresses those broader impacts.

I also think it is important to emphasize that survivorship begins at diagnosis, not only after treatment ends. There are opportunities throughout the cancer journey to improve quality of life, help patients manage symptoms, support healthy lifestyle changes, and empower patients with education and resources that may positively influence both their daily lives and long-term outcomes.

Finally, I think this is an incredibly hopeful area of oncology. Many survivorship interventions are low-risk, patient-centered, and focused on helping people feel better and function better. As the field continues to grow, I am optimistic that survivorship care will become increasingly integrated into routine oncology practice and that we will continue finding new ways to help patients not only survive cancer but thrive afterward.

Interview with Dr. Tippey:

Dr. Amaris Tippey is a clinical psychologist at SCC, who treats patients and their families. She and other collaborators recently hosted a Photovoice exhibition for survivors of childhood cancer, where participants shared a photograph and a caption that held profound personal meaning for them. I was fortunate enough to attend the event when the exhibit first opened, and I found it incredibly moving.

First, could you share a little about your background and the work you currently do at SCC? I am trained as a licensed clinical psychologist and specialized my training and career pursuits working with patients and families impacted by medical illness. I have been working at SCC for over 10 years. We provided free time limited psychotherapy services to patients and their family members. I provided individual and group therapy, including mindfulness and support for young adults with metastatic cancer. We also have a sizeable training program. In addition, I serve on our patient and family advisory council and protocol management and review committees.

I’d love to hear more about the Photovoice project. What inspired you and your collaborators to bring this exhibition to life? How important is it for these survivors to share their stories, and do you find it beneficial from a mental health standpoint for patients to express themselves through the arts—whether that’s photography, crafting, or music?

I was pulled into the photovoice project to assist with the research aspect as well as partnering with my colleagues to conduct the photovoice groups. We utilized photovoice methodology to assist in identifying impacts of cancer on adult survivors of childhood cancer. We conducted both zoom and in-person groups and requested patients take photos and write captions based on weekly prompts from diagnosis to current day. Each survivor chose one photograph each to enter into the curated gallery event that we invited the survivors, families, and medical professionals to amplify survivors’ voices and raise awareness of the longer-term impacts of childhood cancer. It was a powerful event that generated a lot of positive feedback from attendees. It was also powerful to see the instant connections among the survivors. Many had never met someone who had been diagnosed as a child, so the connection and validation seemed healing.

Absolutely, the arts are such a valuable way for patients and caregivers to express themselves uniquely and process emotions in a way that is enjoyable and promotes improved quality of life. Our cancer center has arts programming that always receives positive feedback from patients.

From what I’ve seen, research suggests a positive correlation between mental health and cancer outcomes. From a survivorship perspective (defining survivorship as end of active treatment) what is important for patients and their caregivers to keep in mind, and what can they do to actively promote better mental health?

It is important to realize that survivorship is unique to each patient and caregiver who has transitioned off of active treatment. It is often surprising to many that psychosocial concerns increase during this transition period. For example, the medical demands decrease significantly and leaves more time to reflect on their experience; there’s less contact with the medical team, some side effects remain that are challenging, or body image issues increase. It varies for everyone and it can be difficult to navigate both the gratefulness at having survived and the negative emotions around the sequelae the experience left. That is normal and valid. Those emotions aren’t mutually exclusive. You can experience both at the same time. I do think it is important to note the large majority of the survivorship research related to mental health and outcomes is correlational and not causal. This is often through secondary variables like treatment adherence, decreased health behaviors, social isolation, etc.

Seeking support, staying socially connected, learning to advocate for yourself and communicate symptoms to either your oncologist or primary care provider, protecting sleep, and rebuild physical functioning gradually, I often suggest a PT eval, re-engaging in pleasurable activities that were set aside during treatment, and re-establishing a sense of relationship outside any patient caregiver dynamic that may have taken priority during active treatment.

Have you been involved in, or are you currently conducting, any research trials focused on survivorship and supportive care? What unique challenges exist in this specific research space?

While I’m not currently conducting a trial, I wanted to highlight some of the research a colleague in my department, Dr. David Morris, has been conducting.

His research program focuses on evaluating the effectiveness and implementation of remotely delivered lifestyle interventions for cancer survivors, with a particular emphasis on individuals treated for breast and gynecologic cancers. His recent projects have examined the impact of this type of intervention on weight management, physical activity, dietary behaviors, quality of life, and psychosocial outcomes following completion of cancer treatment. The overarching goal is to identify accessible approaches that support long-term health and survivorship in populations at elevated risk for cancer recurrence and treatment-related comorbidities, particularly cardiovascular disease.

Complementing these quantitative investigations, they are conducting a qualitative study to explore participants’ experiences with the intervention, including perceived benefits, barriers to engagement, facilitators of behavior change, and recommendations for program improvement. Their findings will inform future refinement and dissemination of remotely delivered survivorship interventions.

A major challenge to advancing this line of research is the limited availability of funding mechanisms for smaller-scale, practice-based studies that do not meet the scope or budget requirements of large federal funding opportunities such as those offered by the National Cancer Institute. Their progress has been further constrained by difficulties establishing collaborative partnerships necessary to support multidisciplinary research efforts and securing pilot funding for some of his projects. These barriers have limited available resources for their project expansion, data collection, and implementation activities, despite the strong clinical relevance and translational potential of this work.

Are there any local, national, or international programs you’d recommend for patients, caregivers, or advocates who want to learn more about the role of mental health in treatment and survivorship?

Locally I would start with psychosocial supports through the cancer center where the patient was treated. They will likely have resources on site or referrals they can make to assist with connecting survivors to services. Nationally, I suggest cancer support community, which is a wonderful organization for patients and families impacted by cancer. Further, the American Psychosocial Oncology Society and the National Coalition for Cancer Survivorship, which has resources and an annual survey around survivorship is a great resource. There may also be specialized organizations and services for specific cancers that are too numerous to list.

Looking to the future, do you hope to host another Photovoice exhibit, or are there other projects you’d like to see made available for the patient community?

Photovoice was such a success. I would love to see it utilized in other cancer populations to elevate patient experiences and voices in spaces where both the public and medical providers could bear witness. It is definitely an effective way to build community, amplify survivor voices, and raise awareness of the ongoing needs of the population prioritized.

I really appreciate you taking the time to answer my questions. Is there anything else you’d like to add on this topic?

I encourage providers and patients to have continued discussion around survivorship. These issues can be dynamic and shifting or not recognized until something may trigger it. I applaud those who engage in this work from both a research and clinical perspective.

Conclusion:

I am so excited to work at a research university like WashU Medicine and to have so many colleagues dedicated to all aspects of cancer survivorship, in both the clinical and trial spaces. While I have highlighted just two of these individuals in this article, there are countless others running support groups, connecting patients with essential services, providing art therapy, researching critical issues like financial toxicity, and creating new trials. They are all doing amazing work for our patients.

I share a deep hope for a future where there is a universal shift in how oncology patients are treated in a survivorship setting: more support services, more mind and body enrichments, and more research to improve care guidelines. Ultimately, it comes down to better overall care.

As we celebrate this year’s Survivorship Month, I urge everyone reading this to take action and help lead this change. If you are a patient or caregiver, share your suggestions with your local cancer center and get involved in advocacy groups. If you are a researcher, pitch new ideas to your departments, write grants and protocols, and engage with survivorship groups at your own institutions.

About the Author:

David Timm, MSc, CCRP, works at Washington University in St. Louis. He serves as a member of the Siteman Cancer Center Patient and Family Advisory Council (PFAC), as well as a general member of the NRG Oncology Patient Advocate Committee and the GI Cancer Committee. Prior to starting his current role as a Medicare Coverage Analyst for clinical trials, he worked as a Research Coordinator for both the GU and GI Oncology research groups.