Cancer and the working-age adult: A clinician’s perspective on what employers are missing in survivorship care

June marks Cancer Survivor Awareness Month—a time to recognize the millions of people living with and beyond cancer. For working-age adults, cancer doesn’t end when treatment does. Many are physically and emotionally changed by the experience. Life rarely returns to “baseline.” In fact, this period—what we call survivorship—is often the most overlooked and under-supported part of the cancer journey. And most employer solutions today focus on just navigation or single-point interventions. But survivorship requires longitudinal care, clinical follow-up, and proactive planning—often for years after diagnosis.

“Many working-age cancer survivors face a lifetime of complex decisions—fertility, chronic symptoms, financial strain, mental health. Yet most support systems stop at remission. That has to change.”

When cancer hits during peak working years

While cancer is still more common later in life, more adults in their 30s, 40s, and 50s are living and working through—and beyond—a cancer diagnosis. As a clinician, I care for many working-age adults who are no longer followed by their oncology teams and are unaware of the long-term health implications of their past treatment. Our systems aren’t built for long-term follow-up, and we’re missing critical opportunities to protect survivors’ health and quality of life. 

For working-age adults, a cancer diagnosis is not only clinically complex, but also logistically overwhelming. These are people building families, advancing careers, supporting children and aging parents. And a single diagnosis can disrupt everything—from income to identity. 

Key challenges facing working-age survivors: 

• Toxicity of time: Time lost to in-person only appointments and fragmented care
• Financial toxicity: Strain from missed work, travel costs, and ongoing medical bills
• Emotional and mental health: High emotional burden, especially for those also caring for children or aging parents 
• Lifestyle adjustments: Major shifts needed to reduce long-term health risks
• Care fragmentation: Lack of coordination across oncology, primary care, and specialists
• Proactive screening gaps: Missed opportunities to detect recurrence or secondary cancers early

Why survivorship care needs a reset

Cancer survivorship isn’t a single milestone. It’s an evolving phase of care that includes:

• Recovery from treatment
• Screening and management of long-term and late-onset side effects
• Mental and emotional health care and peer support
• Fertility and reproductive health decisions
• Monitoring for recurrence, cancer prevention, and cancer screening 
• Return-to-work planning—and reentry into life after treatment
• Staying up to date on recommended screenings including genetic evaluations, which may also have implications for family members

“Survivorship for working-age adults is a balancing act—between moving on and staying vigilant, between trying to plan a future, addressing long-term health, and managing the uncertainty of recurrence.”

Three critical questions for employers

If you’re supporting a multigenerational workforce, I encourage you to ask:

1. Do you have the right clinical care model in place?
Working-age adults with a history of cancer face complex medical, emotional, and financial challenges.  Many fall into care gaps—no longer followed by their oncologist, but not well supported by standard primary care. They need oncology-led teams who understand aggressive early-stage treatment, and long-term follow-up.

2. Are you identifying risk early enough to change outcomes?
Working-age adults with a personal or family history of cancer are at higher risk for subsequent cancers. At Color, nearly a quarter of individuals who complete our risk assessment are identified as high-risk for at least one cancer. Missing those individuals is a lost opportunity for prevention.

3. Are you supporting life after treatment?
Return-to-work support should go far beyond a start date. Survivors often face long-term fatigue, chemo brain, anxiety, and ongoing surveillance. Fertility may still be unresolved. Mental health support isn’t optional—it’s essential. If these aren’t built into your program, you’re not delivering comprehensive Cancer Care.

Survivorship care: Where employers fall short

Here are the common gaps I see:

• No risk-based screening—meaning preventable cancers aren’t caught early
• Delays in fertility consults—costing patients critical reproductive options before and after treatment
• Lack of clinical follow-up—especially for survivors outside major health systems
• Limited mental health integration—leaving emotional recovery unaddressed
• Rigid return-to-work models—ignoring long-term cognitive and physical side effects

“We’re doing a disservice when we treat survivorship as a checkmark. It’s not an end—it’s a new phase of care.”

A cancer survivor support checklist for employers

Act on risk early:
☐ Do you offer cancer risk assessments based on family history, genetics, and other factors—not just age?
☐ Is genetic testing affordable and accessible for individuals with a family history of cancer or a personal history of cancer? 

Offer specialized clinical care:
☐ Can employees access multidisciplinary, oncology-led teams?
☐ Do your programs support time-sensitive reproductive health decisions during cancer treatment?
☐ Do survivors have access to mental and emotional support?
☐ Do survivors have long-term access that addresses the lasting impacts of cancer and its treatment?

Support true survivorship:
☐ Are return-to-work plans flexible and designed for long-term recovery?
☐ Is mental health support embedded in the Cancer Care journey?
☐ Can employees connect with peer or professional support—virtually and judgment-free?

Go beyond navigation:
☐ Are you moving beyond referrals and logistics to focus on clinically-informed, long-term care? 
☐ Do your benefits close gaps like late diagnosis, inadequate follow-up, or neglected survivorship care?

The bottom line

This Cancer Survivor Awareness Month, let’s challenge outdated assumptions about survivorship—and design programs that reflect the clinical and emotional realities of life after cancer.

At Color, our Virtual Cancer Clinic was built for this reality: risk-informed, oncology-led, and accessible from anywhere. It’s how we help patients move forward—with the care they need, not just the care they’re offered.

“With the advances in medicine, we have more long-term survivors of cancer. Long-term cancer survivors have unique healthcare needs. Access to a survivorship clinic enables patients and their primary care providers to stay up-to-date on current guidelines regarding survivorship care.”

Looking to better support the cancer survivors already in your workforce?
Let’s talk about how Color partners with employers to deliver clinical, compassionate, and continuous care—before, during, and long after treatment: learnmore@color.com