Finding Yourself Again: What Cancer Rehabilitation Teaches Us About Healing the Whole Person
The cancer journey doesn't end when treatment does, and for many Australians in midlife and beyond, what comes next can feel just as daunting as what came before.
When Treatment Ends and Recovery Begins
For the thousands of Australians living beyond a cancer diagnosis, the finish line of active treatment is time when many individuals emerge from surgery, chemotherapy or radiotherapy with physical impairments, depleted energy, and a profound sense that something essential about themselves has been altered.
This experience — of feeling lost in the cancer journey, of wrestling with a changed body and an uncertain future — is not just a physical phenomenon. It is psychological, social, spiritual, and deeply personal. And for midlife and older adults, who make up the majority of cancer survivors in Australia, the road to recovery often requires more than rehabilitation in the physical sense.
Two Australian studies, conducted by Reynolds, Cole, Walmsley and Poulos at HammondCare's Greenwich Hospital in Sydney — the first multidisciplinary cancer-specific inpatient rehabilitation unit in Australia — offer a rare window into this experience from both sides of the care relationship: the individuals living through it, and the health professionals supporting them.
What the Research Shows
The Patient Perspective
In a 2022 study published in the European Journal of Cancer Care, Reynolds and colleagues interviewed 22 cancer survivors (aged 51–87) before and after their stay at an inpatient rehabilitation unit in Sydney. Using Interpretive Phenomenological Analysis — a method designed to illuminate the lived meaning of experience — the researchers identified one central, overarching theme: Essence of Self in the Cancer Trajectory.
This theme captured something profound. Participants described how cancer had consumed their identity with treatments crowding out ordinary life, and a sense that they had become inseparable from the illness. The rehabilitation phase became a pivotal moment for stepping back, taking stock, and beginning to separate their sense of who they are from what had happened to them.
Two narrative threads emerged. Looking backward, participants grappled with the toll the cancer journey had taken — physical suffering, social isolation, dependency on others, anxiety about prognosis, and in some cases, confronting their own mortality. Looking forward, many began to find footing again — cautious acceptance, a renewed sense of hope, and in many cases, a genuine sense that they had grown through the experience.
Notably, despite significant gains in physical function, a recurring theme was that emotional and psychosocial support had been insufficient throughout the cancer journey — not just during rehabilitation, but from the moment of diagnosis. As Reynolds et al. (2022) conclude, the findings reinforce the importance of a holistic approach to rehabilitation that encompasses mind, body, and spirit.
The Health Professional Perspective
A companion study published in 2019 explored the experiences of 14 multidisciplinary health professionals — physiotherapists, nurses, psychologists, social workers, dieticians, pastoral carers and others — working within the same inpatient unit. The central shared theme in this study was Therapeutic Community: a sense of deep mutual commitment and person-centred care, despite the considerable pressures of the role.
Health professionals described the unit as a place of healing and hope, where patients who had arrived feeling hopeless were supported toward strength and independence. But they also identified systemic constraints such as limited staffing, insufficient counselling resources, gaps in communication between oncology and rehabilitation services — that made it difficult to provide the full depth of care they believed their patients needed.
Several staff members reflected that every patient could potentially benefit from psychological support, yet access to a psychologist or social worker was not universal. The moral weight of knowing what was needed but being unable to always provide it, was a recurring source of distress for the team.
What are the unmet psychological needs of cancer survivors?
Cancer survivors commonly report unmet needs in emotional wellbeing, information about their condition, and psychosocial support; areas that often go unaddressed after active treatment ends. A 2019 systematic review by Lisy and colleagues, confirmed these gaps remain prevalent among Australian survivors.
The Australian Institute of Health and Welfare reports that around 71% of cancer diagnoses in Australia occur in people aged 60 and over. For this age group, cancer and its treatment intersect with other age-related challenges including managing independence, navigating shifting relationships, and finding meaning in the later chapters of life.
This is not a small or peripheral concern. As treatment advances improve survival rates — Australia's five-year cancer survival rate rose from 48% to 68% between the late 1980s and early 2010s (Australian Institute of Health and Welfare, 2014) — the population of people living with the long-term consequences of cancer continues to grow. The question of how they live, not just that they survive, becomes increasingly important.
Reclaiming the Self After Cancer
What the Reynolds et al. (2022) study illuminates so clearly is that cancer rehabilitation is not simply a physical endeavour. The body and the self are inseparable.
Participants in this research described how cancer had dominated their sense of identity — one participant reflecting that it had become something she could live with, not something that defined her. This kind of meaning-making, what psychologists call psychological growth, does not happen automatically or in isolation. It requires space, reflection, and often, skilled support.
The rehabilitation phase, the research indicates, can be a particularly fertile time for this kind of psychological work. Once the immediate survival demands of treatment have been met, people tend to have the psychological bandwidth to begin processing what has happened — to grieve losses, to reassess priorities, and to begin imagining a life beyond cancer.
Aligned with Maslow's hierarchy of needs, as Reynolds et al. (2022) note, once lower-order survival needs are addressed, higher-order needs for meaning and self-understanding naturally emerge. This may explain why psychological and psychosocial support during rehabilitation — not just afterwards — matters so much.
For midlife and older adults in particular, this chapter can prompt deeper exploration of meaning with questions of identity, mortality, contribution, and connection. Far from being a sign of weakness, engaging with these questions is part of what it means to heal.
Upside Stories: Where This Research Connects
At Upside Stories, we support individuals approaching midlife and older adults, caregivers, and those navigating major health transitions. If this article resonated with you, please reach out for a free 20-minute consultation to see if we are a good fit for you.
References & reading
Australian Institute of Health and Welfare. (2017). Cancer in Australia 2017 (Cancer series number 101, Cat. No. CAN 100). AIHW.
Lisy, K., Langdon, L., Piper, A., & Jefford, M. (2019). Identifying the most prevalent unmet needs of cancer survivors in Australia: A systematic review. Asia-Pacific Journal of Clinical Oncology, 15, e68–e78. https://doi.org/10.1111/ajco.13176
Reynolds, N. L., Cole, A. M., Walmsley, B. D., & Poulos, C. J. (2019). Multidisciplinary healthcare providers' experience of working in an inpatient cancer rehabilitation unit in Sydney, Australia. European Journal of Cancer Care, 28(6), e13162. https://doi.org/10.1111/ecc.13162
Reynolds, N. L., Cole, A. M., Walmsley, B. D., & Poulos, C. J. (2022). Australian inpatient cancer rehabilitation as seen by patients receiving care pre and post intervention: Insights into unmet needs in the cancer and rehabilitation journey. European Journal of Cancer Care, 31(6), e13681. https://doi.org/10.1111/ecc.13681
Silver, J. K., Baima, J., & Mayer, R. S. (2013). Impairment-driven cancer rehabilitation: An essential component of quality care and survivorship. CA: A Cancer Journal for Clinicians, 63, 295–317. https://doi.org/10.3322/caac.21186
Stout, N. L., Silver, J. K., Raj, V. S., Rowland, J., Gerber, L., Cheville, A., Ness, K. K., Radomski, M., Nitkin, R., Stubblefield, M. D., Morris, G. S., Acevedo, A., Brandon, Z., Braveman, B., Cunningham, S., Gilchrist, L., Jones, L., Padgett, L., Wolf, T., … Chan, L. (2016). Toward a national initiative in cancer rehabilitation: Recommendations from a subject matter expert group. Archives of Physical Medicine and Rehabilitation, 97(11), 2006–2015. https://doi.org/10.1016/j.apmr.2016.05.002
