Even though they've managed to conquer their disease, many cancer survivors still cope with emotional and physical effects that last for years, a new study finds.

"A cure is not necessarily synonymous with total resumption of good health," researcher Dr. John Wingard, director of the blood and marrow transplant program and deputy director of the University of Florida Shands Cancer Center, Gainesville, said in a prepared statement.

The study included 662 breast cancer, leukemia or lymphoma survivors who had undergone bone marrow transplantation. On average, the patients were evaluated seven years after transplantation. However, some reported post-treatment problems that lasted up to 20 years, according to the study, which appears in the current issue of the Journal of Clinical Oncology.

Lingering sleep and sexual problems, pain, cognitive problems and overall poor physical well-being are among the issues often reported by many cancer survivors, Wingard said.

For example, about 30 percent of the cancer survivors reported symptoms pointing to clinical depression, compared to about 8 percent of those in a control group of healthy people.

Wingard also noted that intensive chemotherapy and radiation treatment can cause many patients to experience physical complications such as infections or toxicity. Patients and their families often have to travel long distances to treatment centers or spend weeks or months living in a temporary residence. Their work is disrupted and they often have to cope with high health-care costs and other financial challenges, the study found.

"All of this occurs in the setting of a considerable amount of anxiety about whether the transplant is going to be successful, whether the cancer is going to be controlled, and whether potentially lethal complications will occur during the therapy. The individual and the family are subjected to a pressure cooker of emotions and challenges they need to face," Wingard said.

He said the findings illustrate the need for doctors to help cancer patients cope with the trauma of cancer diagnosis and treatment, as well as the stresses they face in the aftermath.

Wingard stressed that for some survivors, the post-cancer phase was also a time of tremendous psychological and interpersonal growth in which they experienced strengthened relationships, a renewed appreciation of life, deepened spirituality, increased empathy and a reordering of priorities.

"One unique facet of this study was that it also looked at good that came out of facing a life-threatening illness," Wingard said.

"What we found was that a number of the survivors reported psychological growth and that this positive finding might have leavened some of the losses they experienced. For that reason, many of them, when balancing positives and negatives, felt that their life was better," the Florida researcher said.

"Some pursued a new career, others found strength in renewing relationships with spouses, family and friends, reassessing what was important to them in life," he said.