There’s good news and not-so-good news when it comes to cancer treatment and survival rates these days. The best news? Cancer death rates are now at a 25-year low, and while there are still disparities, the death rates between Caucasian and African-American cancer patients have significantly narrowed as well. To what is this good news attributable? Certainly improvements in detecting cancer and advances in treatments, as well as behavior modifications such as smoking cessation. In fact, we’re seeing treatment advancements come at such a steady pace that there is now on the horizon the option of cancer treatments being available in the home setting rather than patients needing to go to outpatient clinics or physician offices for chemo or radiation.

The flip side to much of this progress, however, are the costs involved, both financial and emotional, in addition to health problems that remain. While cancer patients are surviving longer than ever, there are huge financial bills that are not always covered by insurance and that can result in financial and emotional hardship, including anxiety about unpaid bills and decisions to forego or delay care because of finances. Moreover, cancer survivors who now live longer than was ever thought possible are often in uncharted territory, not followed by oncologists and uncertain what health hurdles they may face in the future, due to prior cancer treatments or disease recurrence.

And while cutting edge treatments may be more available to larger numbers of people, and new technologies are coming to market to help support cancer patients, there is also the growing disparity between patients with money and those who are less well off– who may not see doctors as early as they should or who may not have access to the most up-to-date treatments, or whose lifestyle (such as smoking or obesity) continues to put them at risk for cancer. So before we celebrate the cancer success stories in our midst, we also need to soberly evaluate the disparities in access and the financial and health uncertainties that accompany long term survival.