More Americans than ever before are living with cancer — and experts say it’s both a blessing and a challenge.

Today, more than 18 million Americans are cancer survivors, including many still living with the disease. The National Cancer Institute projects that over 690,000 people will be living with stage-four or metastatic melanoma, breast, bladder, colorectal, prostate, and lung cancers in 2025.

Advances Extend Lives

Thanks to better diagnostics, early screening, and breakthrough therapies, survival rates continue to rise. Keytruda, an immunotherapy drug first approved in 2014, has become one of the world’s top-selling medications and is now used across 18 cancers.

“Just the availability of the therapeutic options and their advances has been tremendous,” said Dr. Robin Zon, past president of the American Society of Clinical Oncology.

While cancer still causes more than 600,000 deaths in the U.S. each year, patients with late-stage disease are living longer. Survival beyond five years after a stage-four diagnosis is now more common compared to just two years ago.

Challenges

Longer life brings new struggles. Survivors face the emotional toll of never being fully free from cancer and the financial strain of ongoing scans, treatments, and travel for care. Support from friends and family often fades over time, leaving many patients to cope alone.

Zon co-authored new recommendations urging that metastatic cancer survivors gain access to programs typically reserved for patients who have finished treatment.

A “Good Problem” to Have

Doctors are now treating health issues that once seemed irrelevant for advanced cancer patients.

“Twenty years ago, patients with stage-four lung cancer didn’t worry about high cholesterol issues because the odds were they wouldn’t live long enough to face them,” said Dr. Norman Ashraf, a medical oncologist at Tampa General Hospital. “Now they’re living 10 to 15 years, and we have to worry about their cardiovascular health. It’s a good problem to have.”

While cancer remains a deadly disease, for millions, new treatments are turning it into a long-term, manageable condition — one that comes with new challenges, but also with more years of life.