Chicago, IL – Female cancer survivors are significantly more likely than their male counterparts to suffer from long-term cancer-related fatigue and depression, according to new research presented Tuesday at the annual meeting of the American Association for Cancer Research (AACR).

The findings, which have not yet been peer-reviewed or published in a medical journal, suggest that women not only experience more severe side effects during cancer treatment but also face enduring physical and mental health challenges long after remission.

The study was led by Dr. Simo Du, an internal medicine resident physician at NYC Health + Hospitals/Jacobi. Dr. Du and her colleagues examined data from 1,555 adult cancer survivors collected through the 2015–2016 and 2017–2020 cycles of the National Health and Nutrition Examination Survey (NHANES), a representative national dataset in the United States. The participants responded to questions on their mental and physical well-being, including symptoms such as fatigue, hopelessness, poor appetite, sleep difficulties, and suicidal ideation. They also provided information about their levels of physical activity.

The researchers estimate that their findings are reflective of over 25 million cancer survivors nationwide, encompassing more than 20 cancer types, including breast, prostate, colon, skin, and cervical cancers.

Women Report Higher Levels of Post-Treatment Fatigue and Depression

The study found that women were 69% more likely than men to report cancer-related fatigue and 58% more likely to report depression. While fatigue is known to affect up to 80% of cancer patients, women were 1.5 times more likely to experience it than their male peers.

The disparity could be linked to biological, pharmacological, and psychosocial factors. Women typically exhibit stronger immune responses to treatment, leading to heightened inflammation. They also metabolize medications more slowly than men, potentially resulting in higher concentrations of drugs in their systems and more pronounced side effects.

Furthermore, female cancer patients are more likely to undergo long-term hormone therapies such as tamoxifen for breast cancer, which are known to cause fatigue and mood disorders. These therapies are often prescribed for five to ten years post-treatment to reduce the risk of recurrence.

Dr Carolyn Gotay, a professor emeritus of population and public health at the University of British Columbia who was not involved in the study, noted that the emotional and physical consequences of cancer treatment could last for years. “Cancer treatments damage both healthy and cancerous cells, leading to a range of late effects including fatigue, infertility, and cognitive impairment,” she said.

Psychosocial and Gender Norms May Also Play a Role

Beyond biological differences, the study’s authors and independent experts suggest that traditional gender roles may exacerbate post-treatment struggles for women. Women often bear greater responsibility for caregiving and household duties, which may increase stress and fatigue.

“Many of the women I see in clinic report that they are too exhausted to complete everyday tasks like shopping, bathing, or cooking,” Dr. Du said. “These aren’t just side effects—they’re significant quality of life issues.”

Interestingly, the study also found that male survivors were more likely to report suicidal ideation. This aligns with national data showing that men in the general population have higher suicide rates. Experts believe this may stem from social expectations around masculinity and the pressures associated with traditional provider roles.

Exercise Linked to Improved Mental and Physical Health Outcomes

The study also evaluated the impact of physical activity on cancer-related symptoms. It found that survivors who engaged in moderate-intensity exercise, such as walking or cycling, had a 50% lower risk of experiencing fatigue. Vigorous exercise did not offer the same benefit for energy levels, but both moderate and intense activity were associated with a two- to five-fold reduction in depression risk.

These findings echo a 2024 meta-analysis of 113 randomized controlled trials, which concluded that exercise, cognitive behavioural therapy (CBT), and mindfulness-based interventions can significantly improve cancer-related fatigue during and after treatment.

“We frequently prescribe medications for post-cancer symptoms,” said Dr. Du. “But when it comes to fatigue, exercise may be more effective than pharmaceutical interventions.”

Looking Ahead: Quality of Life as a Core Focus in Cancer Care

While the medical community has made substantial progress in improving cancer survival rates, researchers emphasize that survivorship care must now prioritize quality of life.

“Cancer is increasingly being treated as a chronic condition, and as more people survive, attention must shift to their long-term well-being,” said Dr. Joseph Unger, a biostatistician at the Fred Hutch Cancer Center in Seattle, who was not involved in the study. “Patients want to do more than survive; they want to thrive.”

Unger noted that while exercise may alleviate symptoms, further research is needed to understand the underlying causes of post-treatment disparities, particularly for women.

Dr Gotay added that societal attitudes must shift to better support survivors. “Many people believe that life should return to normal after treatment. But for many survivors, that’s not the case. We need to normalize the experience of post-treatment fatigue and depression so that patients don’t feel isolated or inadequate.”

The study underscores the pressing need for more gender-sensitive cancer survivorship care. Health providers are encouraged to monitor post-treatment symptoms closely and recommend supportive strategies such as structured exercise programs, mental health counselling, and holistic care plans to address the lingering effects of cancer treatment, particularly for women.

As survivorship becomes an increasingly central focus in oncology, experts hope that future interventions will go beyond extending life and focus more on improving how survivors live.