Author
Biodata
Safura Shiraz (Student ID: 506927) is a
part-time MSc Nursing student at the Aga Khan University School of Nursing and
Midwifery (AKU-SONAM), Karachi, Pakistan. She holds a registered nurse license,
a Bachelor of Science in Nursing (BScN) from AKU, and a pupil midwifery certification from Dr. Ziauddin University. With a strong clinical background,
Safura has hands-on experience in cancer care nursing, particularly in
radiation, chemotherapy, and pediatric oncology units.
Currently, she is working as a research associate in the Department of Pediatrics and Child Health at AKU, contributing
to a longitudinal cohort study on the neurodevelopmental impact of the
environment in early childhood, funded by the Bill and Melinda Gates Foundation
and led by Dr. Sidra Kaleem.
Safura has actively engaged in
professional development through numerous certifications and workshops,
including those on adult oncology, ACLS, emergency obstetric and newborn care, early childhood development, and health system transformation. Passionate about
community health, she serves as a community ECD educator and conducts health
education sessions for older adults on non-communicable diseases.
Her diverse experiences in clinical
care, research, and education reflect a deep commitment to advancing health
outcomes and nursing practice. Through her writing, she aims to inspire,
inform, and advocate for patient-centered, hope-driven care, especially for
vulnerable populations.
Introduction:
What truly happens after the final
chemotherapy session or the last radiation dose? When a woman hears the words,
“You’re done with treatment,” the moment is often bittersweet. While it may
mark the end of difficult and exhausting medical interventions, it also marks
the beginning of a new and unfamiliar chapter, one often filled with emotional
uncertainty, fatigue, and vulnerability. For
many women with breast cancer, this milestone brings a deep sense of relief
mixed with fear, vulnerability, and uncertainty. The so-called "end of
treatment" often introduces a quieter, less supported phase. This phase
lacks the structure, frequency, and emotional support of clinical care. Amidst
this emotional and physical landscape, one powerful force remains both
underappreciated and underutilized: hope. As a registered nurse with firsthand
experience in radiation, oncology, and chemotherapy units, I have observed the
unsettling silence that follows medical interventions. This is where true
healing begins. This is where hope becomes medicine.
Hope is not just an abstract idea or fleeting emotion. It is a powerful psychological and emotional resource. It acts as a bridge between surviving and thriving. Yet, in many models of post-treatment care, hope remains undervalued, underused, and largely unaddressed. Drawing from both nursing practice and research, this blog advocates for a transformation. We must view hope as a cornerstone of post-treatment care to promote emotional healing, resilience, and long-term quality of life for women who have survived breast cancer. In this blog post, I aim to explore the untold power of hope in the lives of women recovering from breast cancer and to advocate for its integration into post-treatment care.
Survivorship Is Not a Conclusion. It Is a Complex
Transition
The period following treatment is often
misunderstood as a return to "normal life." In reality, many
survivors face new physical, emotional, and social challenges. Fatigue, altered
body image, disrupted self-identity, and fear of recurrence are common.
Research indicates that up to one-third of breast cancer survivors experience
anxiety and depression within the first year following treatment
(Currin-McCulloch et al., 2021). For many
women, the end of active treatment marks a confusing and disorienting time.
While their physical battle against cancer may have concluded, emotional wounds
often remain unhealed. Society celebrates their survival, yet they are left
alone to manage persistent fatigue, altered body image, fear of recurrence, and
a changed sense of self. With fewer appointments and reduced interaction with
medical teams, many women report feeling abandoned.
In my clinical practice, I have seen
women express a mix of relief and confusion. The steady rhythm of hospital
visits suddenly stops, and many describe feeling lost. Medical scans may show
no evidence of disease, but survivors frequently report feelings of
abandonment, isolation, and psychological vulnerability. This liminal space,
neither fully ill nor completely well, is often overlooked in care plans. In my
own nursing practice, patients have described this stage as a confusing space
between illness and wellness. They no longer identify as patients but do not
feel fully healthy either. This liminal phase can be isolating. In these
moments, hope is not just comforting. It is essential.
This is where hope becomes not an
optional extra but a necessary component of recovery. It offers structure,
motivation, and direction during a time when survivors feel most uncertain. It
empowers women to redefine their identity, set new goals, and begin to trusttheir bodies again.
The Science of Hope: A Clinical and Theoretical
Perspective
Hope is not simply wishful thinking. According
to Snyder’s Hope Theory, hope consists of two essential elements: agency, which
refers to the motivation to pursue goals, and pathways, which reflect the
perceived ability to achieve those goals (Feldman & Corn, 2023). This model
offers a practical, measurable, and evidence-based understanding of hope.
This framework shows that hope is both cognitive
and emotional. It can be taught, measured, and cultivated.
Hope can influence health behaviors, improve coping, and build emotional resilience. Research shows that individuals with higher levels of hope tend to adhere to treatment plans, maintain healthy behaviors, and nurture strong social connections. A longitudinal study in Wuhan with over 500 breast cancer survivors found that hope was positively linked to emotional strength, physical adaptation, and successful reintegration into daily life (Xiong et al., 2024). Similarly, a cross-sectional study in China reported that women with lighter symptom burdens and strong spiritual beliefs demonstrated higher levels of hope and improved quality of life (Li et al., 2021). These findings suggest that hope is not just a nice idea, it is a clinically relevant variable that can significantly improve health outcomes. Hope, in this context, becomes a clinical asset. It deserves a central role in survivorship planning.
Nurses as Catalysts of Hope in
Survivorship
Throughout the cancer journey, nurses
remain a constant presence. This positions us uniquely to foster and sustain
hope. Whether through therapeutic conversations, spiritual care, or simply
listening, we offer a kind of healing that transcends medical prescriptions.
Interventions such as mindfulness-based
cognitive therapy, motivational interviewing, narrative journaling, and
structured peer support have all been shown to boost psychological well-being.
A recent study found that mindfulness-based therapy significantly reduced
anxiety and enhanced hope and spiritual peace in women with breast cancer
(Arefian & Asgari-Mobarake, 2025). Another study highlighted that nurse-led
group interventions helped women reshape their cancer experiences and find
renewed purpose (Chang et al., 2023).
In my own clinical practice, the power of simple human connection became clear. Listening to a patient's fears, holding her hand in silence, or encouraging her to dream again—these moments had a powerful impact. They became acts of healing. They affirmed that nursing interventions grounded in empathy and presence can serve as powerful instruments of hope. These are not grand gestures but everyday interactions that can influence how a survivor copes, recovers, and grows.
Systemic Barriers to Hope in Current
Care Models
Despite the proven benefits of hope,
most post-treatment care plans remain focused on physical recovery alone.
Emotional, spiritual, and existential dimensions of healing are frequently
overlooked. In many healthcare settings, especially those with limited
resources, there is little access to psycho-oncology support. Survivors often
say they feel "medically cured but emotionally wounded" (Peera et
al., 2024). This is more than a clinical oversight. It is a policy failure.
Cultural, religious, and social factors
also influence how hope is experienced and sustained. For example, research
from Malaysia shows that spirituality plays a significant role in shaping hope
and quality of life among Muslim women with breast cancer (Pahlevan Sharif et
al., 2021). Another study in Serbia found that age, marital status, and
education levels influenced hope levels (Gavrilovic et al., 2023). These
findings suggest that culturally sensitive and individualized care is essential
to supporting hope. Yet most survivorship interventions do not reflect these
important variables. A one-size-fits-all approach simply does not work.
Without addressing these broader aspects of healing, we risk undermining the very gains made through medical treatment. To address this gap, care systems must become more inclusive, patient-centered, and culturally responsive.
Reimagining Hope as Clinical Priority
We need to redefine survivorship care by
integrating hope as a clinical outcome. Hope should be measured, supported, and
nurtured as deliberately as any physical marker of health. Nurses have the
skills, insight, and patient relationships to lead this transformation. Some
key components of hope-centered care could include:
· Emotional readiness assessments
and personalized goal setting before discharge
· Telehealth follow-ups that
include emotional check-ins, not just lab reviews
· Peer-led group discussions that
promote shared experience and resilience
· Educational programs that help
nurses identify depression and offer hope-enhancing strategies
· Narrative therapy sessions where
survivors can reflect on their experiences and create meaning
These strategies can shift survivorship care from a disease-focused model to a survivor-focused one. They allow hope to emerge not as an afterthought, but as a core component of healing.
Conclusion: Hope Is Healing
Hope is not just an emotion. It is a
vital form of psychological medicine. It must be embedded in survivorship care,
respected in clinical training, and reflected in policy frameworks. When hope is absent from care, survivors are left in
emotional limbo. But when hope is nurtured through compassionate nursing,
structured interventions, and culturally informed practices, it becomes a
powerful driver of recovery.
Nurses, researchers, policymakers, and
educators must collaborate to place hope at the heart of post-treatment care. Survivorship
care plans must move beyond medication and follow-up scans. They must also
provide the emotional scaffolding needed to support true recovery. We must
champion policies and practices that recognize emotional well-being as equal in
importance to physical recovery.
Let us not define healing solely by the absence of disease. Let us define it by the presence of purpose, the return of joy, and the power of hope. Survivorship should be more than survival. It should be life, lived fully and fearlessly. Let us remember that healing begins not when treatment ends, but when hope takes root. Now is the time to reimagine survivorship. Healing does not end when treatment does; it begins again, with hope lighting the way forward. True healing is not found in discharge summaries or scan results; it is found in the lives women rebuild after cancer, with hope lighting the path forward.
References
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Mindfulness-integrated Cognitive Behavioral Therapy reduces pain and
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Chang, Y. C., Tseng, T. A., Lin, G. M., Hu, W. Y., Wang, C. K.,
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