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The Evidence

Why journaling, nature, and community?

Because the evidence points here. Each element of the Women Beyond Cancer programme is grounded in published research.

Rebecca Perkins in nature

The Problem Nobody Talks About

The end of treatment is not the end of the experience.

We have made enormous progress in treating cancer, but the period after treatment can still be one of the most psychologically demanding parts of the journey. In a large UK prospective survey of people finishing treatment, 30% reported more than five moderate or severe unmet needs at the end of treatment — and for 60% of that group, the situation had not improved six months later. The most commonly reported unmet needs were psychological, especially fear of recurrence.[1]

Loneliness and disconnection are also common. A 2024 UK study of 5,835 people living with and beyond cancer found that 19% reported higher loneliness, and those participants were less likely to meet recommendations for physical activity, fruit and vegetable intake, and smoking avoidance.[2] In other words, isolation is not just emotionally painful; it is closely tied to the everyday behaviours that support recovery.

30%

reported more than five moderate or severe unmet needs immediately after treatment.
Armes et al., J Clin Oncol, 2009

19%

of 5,485 UK adults living with and beyond cancer reported higher loneliness.
Smith et al., BMC Public Health, 2024

This is why survivorship support matters. The challenge after treatment is not simply “getting back to normal”; it is navigating uncertainty, fatigue, identity change, and the sudden absence of the clinical structure that carried many women through treatment in the first place.[1][2]

Pillar One

Therapeutic Journaling

Expressive writing is one of the most studied low-cost psychosocial practices in cancer care. A 2023 systematic review and meta-analysis covering 34 studies and 4,316 participants found improvements in fatigue, passive mood, and the physical dimension of quality of life, even though effects on anxiety and depression were not consistent across all studies.[3]

That nuance matters. An earlier meta-analysis of 16 randomized trials concluded that expressive writing is not a universal fix for every cancer survivor, but it may be more helpful for subgroups facing higher distress or lower emotional support.[4] In practice, writing tends to work best when it is structured, intentional, and supported rather than left completely open-ended.

What matters in Women Beyond Cancer is not journaling as diary-keeping. It is guided reflective practice: prompts that help women name what has happened, make meaning of it, and gradually rebuild a sense of continuity and agency.[3][4]

Pillar Two

Forest Bathing and Time in Nature

The practice of Shinrin-yoku — forest bathing — has moved well beyond the language of wellness trends and into a growing research literature. It refers not to strenuous exercise, but to slow, sensory immersion in a natural environment.

A 2023 systematic review and meta-analysis of 36 studies involving 3,554 participants found that forest bathing significantly reduced symptoms of depression and anxiety.[5] A 2021 meta-analysis focused specifically on forest therapy likewise reported significant improvements in both depression and anxiety across 20 studies.[6]

The physiological evidence is more mixed than the psychological evidence, but the overall direction is encouraging: nature-based interventions appear to reduce stress and restore calm without asking people to push through or perform. For women coming out of cancer treatment, that combination of gentleness, embodiment, and emotional regulation is highly relevant.[5][6]

Pillar Three

Peer Community and Belonging

Perhaps the most underestimated element of life after cancer is loneliness — and how little-discussed it can be once treatment ends. The evidence above suggests that isolation remains common well into survivorship and is tied not only to distress, but also to the everyday health behaviours that support long-term recovery.[2]

Peer support addresses something professional care alone cannot: the relief of being understood by someone who does not need the experience explained. A 2023 systematic review of 18 randomized controlled trials found small but meaningful benefits of peer-to-peer support for outcomes such as depression and anxiety, coping, sexual functioning, and cancer-specific quality of life, with particularly promising findings in breast cancer and face-to-face settings.[7]

The fortnightly peer support groups within Women Beyond Cancer are therefore not incidental conversation. They are a deliberately held space designed to reduce isolation, strengthen coping, and restore a sense of belonging at a point where many women feel unexpectedly alone.[2][7]

A note on the evidence

The Women Beyond Cancer programme does not claim to be a clinical intervention, and it is not a replacement for medical or psychological care. What it offers is evidence-informed community support — a programme designed with genuine care and grounded in the best available research on what helps women recover, reconnect, and find themselves on the other side of cancer treatment.

Every element of the programme reflects a deliberate choice. The combination of journaling, nature, and peer community is not a collection of wellness trends. It is a considered, compassionate response to what the evidence — and lived experience — tells us women actually need.

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References

Selected studies and sources

These are the key papers used to ground the claims on this page. They are not exhaustive, but they reflect the evidence base behind the programme.

  1. Armes J, Crowe M, Colbourne L, et al. Patients' supportive care needs beyond the end of cancer treatment: a prospective, longitudinal survey. J Clin Oncol. 2009;27(36):6172-6179. PubMed
  2. Smith S, Lally P, Steptoe A, Chavez-Ugalde Y, Beeken RJ, Fisher A. Prevalence of loneliness and associations with health behaviours and body mass index in 5835 people living with and beyond cancer: a cross-sectional study. BMC Public Health. 2024;24:635. PubMed
  3. Abu-Odah H, Su JJ, Wang M, Sheffield D, Molassiotis A. Systematic review and meta-analysis of the effectiveness of expressive writing disclosure on cancer and palliative care patients' health-related outcomes. Support Care Cancer. 2024;32(1):70. PubMed
  4. Zachariae R, O'Toole MS. The effect of expressive writing intervention on psychological and physical health outcomes in cancer patients—a systematic review and meta-analysis. Psychooncology. 2015;24(11):1349-1359. PubMed
  5. Siah CJR, Goh YS, Lee J, et al. The effects of forest bathing on psychological well-being: a systematic review and meta-analysis. Int J Ment Health Nurs. 2023;32(4):1038-1054. Europe PMC
  6. Yeon PS, Jeon JY, Jung MS, et al. Effect of Forest Therapy on Depression and Anxiety: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2021;18(23):12685. PubMed
  7. Kiemen A, Czornik M, Weis J. How effective is peer-to-peer support in cancer patients and survivors? A systematic review. J Cancer Res Clin Oncol. 2023;149(11):9461-9485. Europe PMC