Cancer Wellness Is Not One-Size-Fits-All

Author: Sumairaa Ahmed

Editor: Turjo Rafid

Closing the gates to oncology treatment plans does not equate to the end of a patient’s battle with cancer. For many, what follows remission is an unspoken and unsupported reality: fatigue, isolation, chronic pain, disrupted identity, and the long-term psychological residue of survival (Kittel et al., 2024).

As June 26 marks National Cancer Wellness Awareness Day, health advocates must confront an uncomfortable truth: For Black, Indigenous, and people of colour (BIPOC) in Canada, the pathway to healing is neither linear nor equitable. And while survivorship is often framed as a personal triumph, for many, it occurs in a system that was not entirely built with the BIPOC community in mind.

The term “cancer wellness” is often used as a blanket term, encompassing physical recovery, mental health support, rehabilitation, and re-entry into daily life. Mainstream models of survivorship have been shown to often presume a certain degree of financial security, health literacy, and cultural alignment with Western norms of recovery (Halpern et al., 2016). However, this model collapses when met with the lived realities of racialized Canadians, whose post-cancer journey is frequently interrupted by systemic barriers faced in healthcare. But for BIPOC communities, wellness is not merely a question of provided services—it’s a question of access to such services, language, culture, safety, and belonging. 

For example, cancer wellness entails more than physical recovery; it is an assertion of patient autonomy, the ability of individuals to actively engage with their own care, make informed decisions, and exercise control over their health and well-being (Krist et al., 2017). This ideology is not merely another facet of holistic healing but a crucial restoration of agency that is often diminished throughout a patient’s cancer journey. As such, cancer wellness transcends individual patient care to become a matter of bioethical significance, particularly in the dynamics of patient-physician relationships, where respect for autonomy and shared decision-making must be central.

Yet, for racialized survivors in Canada, this autonomy is persistently compromised by structural and systemic barriers. Linguistic challenges, complex medical jargon, and culturally incongruent care environments create an atmosphere of intimidation and disempowerment. Patients find themselves helplessly distanced from the decision-making processes that shape their recovery, undermining their capacity to advocate effectively for their needs. 

Furthermore, Mistrust in racialized communities only exacerbates this issue further. Canada’s medical history is not immune to the legacies of colonialism and racism. Historical traumas—such as the coerced sterilization of Indigenous women, the intentional withholding of nutrition and medical care from Indigenous children in residential schools, and, though outside Canadian borders, the Tuskegee Syphilis Study—continue to shape how many Black, Indigenous, and racialized communities perceive and engage with healthcare institutions today (Canadian Medical Association., 2024, Cénat et al., 2023). Mistrust, in this sense, is not a barrier to be overcome through patient education alone. It is a structural consequence of epistemic injustice: the denial of racialized individuals as credible knowers of their own bodies. When patients sense that their cultural context is ignored or their concerns are minimized, the patient-physician relationship collapses. Survivors may disengage from follow-up care, hesitate to disclose symptoms, or avoid mental health services altogether, not out of indifference, but out of self-preservation (Hildenbrand et al., 2022). To speak of wellness, then, without addressing mistrust is to ignore the very foundation upon which healing must be built: safety, dignity, and mutual recognition.

Additionally, one must consider socioeconomic disadvantage as a systemic barrier to patient wellness. The high cost of recovery, transportation to follow-ups, out-of-pocket therapy, post-treatment nutrition, and childcare during appointments is limited for many in the BIPOC community. Employment precarity means that time off is rarely paid. Prioritization of survivorship often coincides with return to unstable work that neither accommodates nor acknowledges chronic fatigue, neuropathy, or the trauma of illness.

As such, a physician must reimagine the concept of “healing”. To advocate for cancer wellness while ignoring these truths is to romanticize survivorship while not being politically and structurally informed. It must recognize that health outcomes are not solely biological—they are sociopolitical, shaped by policy, culture, race, and power.

A reimagined model of wellness for BIPOC survivors must include:

• Culturally safe mental health care, led by racialized professionals

• Community-based recovery spaces, embedded in local neighbourhoods

• Translated, plain-language survivorship materials for patients and families

• Financial support programs that recognize the economic toll of healing

• A fundamental shift from patient-blaming narratives to systemic accountability

If we are to truly acknowledge the stories of BIPOC cancer survivors, we cannot simply uplift them. We must actively dismantle the barriers that force them to heal in silence.

References

Canadian Medical Association (CMA). The CMA’s apology to Indigenous Peoples [full statement]. Ottawa: The Association; 2024 Sep. Available: https://digitallibrary.cma.ca/link/digitallibrary586.

Cénat JM, Moshirian Farahi SMM, Bakombo SM, Dalexis RD, Pongou R, Caulley L, Yaya S, Etowa J, Venkatesh V. Vaccine mistrust among Black individuals in Canada: The major role of health literacy, conspiracy theories, and racial discrimination in the healthcare system. J Med Virol. 2023 Apr;95(4):e28738. doi: 10.1002/jmv.28738. PMID: 37185858.

Halpern MT, McCabe MS, Burg MA. The Cancer Survivorship Journey: Models of Care, Disparities, Barriers, and Future Directions. Am Soc Clin Oncol Educ Book. 2016;35:231-9. doi: 10.1200/EDBK_156039. PMID: 27249703.

Hildenbrand GM, Perrault EK, Rnoh RH. Patients' Perceptions of Health Care Providers' Dismissive Communication. Health Promot Pract. 2022 Sep;23(5):777-784. doi: 10.1177/15248399211027540. Epub 2021 Aug 3. PMID: 34344222.

Kittel JA, Seplaki CL, van Wijngaarden E, Richman J, Magnuson A, Conwell Y. Fatigue, impaired physical function and mental health in cancer survivors: the role of social isolation. Support Care Cancer. 2024 Dec 11;33(1):16. doi: 10.1007/s00520-024-09075-0. PMID: 39661200.

Krist, A. H., Tong, S. T., Aycock, R. A., & Longo, D. R. (2017). Engaging Patients in Decision-Making and Behavior Change to Promote Prevention. Studies in health technology and informatics, 240, 284–302.