Background: Cancer survivorship brings numerous challenges extending beyond physical health to include psychological, social, and functional aspects that define the quality of life (QoL) of survivors. Although recognizing that diverse gender experiences lead to different ways of coping with these challenges, many clinical trials fail to account for the distinct constructs of “sex” and “gender,” often conflating the two. This review highlights how gender-related aspects can manifest in core QoL domains for cancer survivors, emphasizing the importance of inclusive and effective support systems and interventions. Summary: While interest in the impact of gender is increasing in cancer survivor research, the terms “sex” and “gender” are still often conflated in research. Gender is a social concept consisting of multiple dimensions, such as gender identity, gender roles and norms, and gender relations. Each of these dimensions can have a distinct impact on the QoL domain of cancer survivors. Research indicates that not gender identity, but gender roles, norms, and relations can significantly influence coping behaviors that, subsequently, impact QoL domains such as physical, emotional, social, and role functioning. Understanding the interplay of gender roles, norms, and their relations with other contextual social factors is crucial for developing inclusive and effective support systems and interventions for cancer survivors. Key Messages: Gender roles and norms impact important QoL domains of cancer survivors. It is important to recognize that gendered behaviors, as a result of internalized or socially desired gender roles and norms, can both help and hinder effective coping with cancer, affecting QoL.

1.
Fitzpatrick
TR
. In:
Fitzpatrick
TR
, editor.
Quality of life among cancer survivors
.
Springer International Publishing
;
2018
.
2.
Firkins
J
,
Hansen
L
,
Driessnack
M
,
Dieckmann
N
.
Quality of life in “chronic” cancer survivors: a meta-analysis
.
J Cancer Surviv
.
2020
;
14
(
4
):
504
17
.
3.
Jochum
F
,
Hamy
A-S
,
Gougis
P
,
Dumas
É
,
Grandal
B
,
Laas
E
, et al
.
Effects of gender and socio-environmental factors on health-care access in oncology: a comprehensive, nationwide study in France
.
EClinicalMedicine
.
2023
;
65
:
102298
.
4.
Bertagnolli
MM
.
Women, power, and cancer: a need for change and a force for progress
.
Lancet
.
2023
;
402
(
10417
):
2053
5
.
5.
Choi
E
,
Becker
H
,
Lu
Q
,
Roth
M
.
Sex differences in comorbid conditions, health behaviors, health care utilization, and health-related quality of life among young adult cancer survivors
.
Support Care Cancer
.
2023
;
31
(
3
):
181
.
6.
Westby
RP
,
Berg
CJ
,
Leach
C
.
Gender, race, BMI, and social support in relation to the health-related quality of life of cancer survivors: a report from the American Cancer Society’s Study of Cancer Survivors II (SCS-II)
.
Qual Life Res
.
2016
;
25
(
2
):
409
21
.
7.
Oertelt-Prigione
S
,
de Rooij
BH
,
Mols
F
,
Oerlemans
S
,
Husson
O
,
Schoormans
D
, et al
.
Sex-differences in symptoms and functioning in >5000 cancer survivors: results from the PROFILES registry
.
Eur J Cancer
.
2021
;
156
:
24
34
.
8.
Saunders
S
,
Hammond
C
,
Thomas
R
.
Exploring gender-related experiences of cancer survivors through creative arts: a scoping review
.
Qual Health Res
.
2019
;
29
(
1
):
135
48
.
9.
Martinez Tyson
D
,
Ruiz
EL
.
Supportive care needs and coping strategies used by latino men cancer survivors
. In:
Advancing the science of cancer in latinos: building collaboration for action
.
Cham (CH)
:
Springer
;
2023
. p.
57
65
.
10.
Sarang
B
,
Bhandarkar
P
,
Parsekar
SS
,
Patil
P
,
Venghateri
JB
,
Ghoshal
R
, et al
.
Concerns and coping mechanisms of breast cancer survivor women from Asia: a scoping review
.
Support Care Cancer
.
2023
;
31
(
9
):
528
.
11.
Hall
M
,
Krishnanandan
VA
,
Cheung
MC
,
Coburn
NG
,
Haas
B
,
Chan
KKW
, et al
.
An evaluation of sex- and gender-based analyses in oncology clinical trials
.
J Natl Cancer Inst
.
2022
;
114
(
8
):
1186
91
.
12.
Jacobsen
PB
,
Jim
HSL
.
Consideration of quality of life in cancer survivorship research
.
Cancer Epidemiol Biomarkers Prev
.
2011
;
20
(
10
):
2035
41
.
13.
Schag
CA
,
Ganz
PA
,
Heinrich
RL
.
CAncer Rehabilitation Evaluation System--short form (CARES-SF). A cancer specific rehabilitation and quality of life instrument
.
Cancer
.
1991
;
68
(
6
):
1406
13
.
14.
Aaronson
NK
,
Ahmedzai
S
,
Bergman
B
,
Bullinger
M
,
Cull
A
,
Duez
NJ
, et al
.
The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology
.
J Natl Cancer Inst
.
1993
;
85
(
5
):
365
76
.
15.
Victorson
D
,
Barocas
J
,
Song
J
,
Cella
D
.
Reliability across studies from the functional assessment of cancer therapy-general (FACT-G) and its subscales: a reliability generalization
.
Qual Life Res
.
2008
;
17
(
9
):
1137
46
.
16.
Schipper
H
,
Clinch
J
,
McMurray
A
,
Levitt
M
.
Measuring the quality of life of cancer patients: the Functional Living Index-Cancer: development and validation
.
J Clin Oncol
.
1984
;
2
(
5
):
472
83
.
17.
Avis
NE
,
Smith
KW
,
McGraw
S
,
Smith
RG
,
Petronis
VM
,
Carver
CS
.
Assessing quality of life in adult cancer survivors (QLACS)
.
Qual Life Res
.
2005
;
14
(
4
):
1007
23
.
18.
Al-Rawashdeh
N
,
Damsees
R
,
Abaza
H
,
Ammar
K
,
Alananzeh
I
,
Abu Ghosh
A
, et al
.
Mapping the supportive care needs and quality of life of adult survivors of childhood cancer at a comprehensive cancer center in the Middle East
.
Sci Rep
.
2024
;
14
(
1
):
12356
.
19.
Ginsburg
O
,
Bray
F
,
Coleman
MP
,
Vanderpuye
V
,
Eniu
A
,
Kotha
SR
, et al
.
The global burden of women’s cancers: a grand challenge in global health
.
Lancet
.
2017
;
389
(
10071
):
847
60
.
20.
Göttgens
I
,
Oertelt-Prigione
S
.
Moving beyond gender identity: the need for contextualization in gender-sensitive medical research
.
Lancet Reg Health Eur
.
2023
;
24
:
100548
.
21.
Fleming
PJ
,
Agnew-Brune
C
.
Current trends in the study of gender norms and health behaviors
.
Curr Opin Psychol
.
2015
;
5
:
72
7
.
22.
Carnahan
LR
,
Zimmermann
K
,
Khare
MM
,
Paulsey
E
,
Molina
Y
,
Wilbur
J
, et al
.
Physical activity and masculinity in rural men: a qualitative study of men recruited from churches
.
Health Educ Res
.
2018
;
33
(
2
):
145
54
.
23.
Peng
B
,
Ng
JYY
,
Ha
AS
.
Barriers and facilitators to physical activity for young adult women: a systematic review and thematic synthesis of qualitative literature
.
Int J Behav Nutr Phys Act
.
2023
;
20
(
1
):
23
.
24.
Grimmett
C
,
Corbett
T
,
Brunet
J
,
Shepherd
J
,
Pinto
BM
,
May
CR
, et al
.
Systematic review and meta-analysis of maintenance of physical activity behaviour change in cancer survivors
.
Int J Behav Nutr Phys Act
.
2019
;
16
(
1
):
37
.
25.
Zhou
J
,
Wang
Z
,
Chen
X
,
Li
Q
.
Gender differences in psychosocial outcomes and coping strategies of patients with colorectal cancer: a systematic review
.
Healthc
.
2023
;
11
(
18
):
2591
.
26.
Richards
AB
,
Davis
K
,
Gooden
RO
.
Assessing the impact of sexual function on perceptions of masculinity among prostate cancer survivors in the United States: findings from the prostate cancer registry
.
Aging Male
.
2020
;
23
(
5
):
496
500
.
27.
Campbell
LC
,
Keefe
FJ
,
McKee
DC
,
Waters
SJ
,
Moul
JW
.
Masculinity beliefs predict psychosocial functioning in African American prostate cancer survivors
.
Am J Men Health
.
2012
;
6
(
5
):
400
8
.
28.
Kim
Y
,
Baker
F
,
Spillers
RL
,
Wellisch
DK
.
Psychological adjustment of cancer caregivers with multiple roles
.
Psychooncology
.
2006
;
15
(
9
):
795
804
.
29.
Krajc
K
,
Miroševič
Š
,
Sajovic
J
,
Klemenc Ketiš
Z
,
Spiegel
D
,
Drevenšek
G
, et al
.
Marital status and survival in cancer patients: a systematic review and meta-analysis
.
Cancer Med
.
2023
;
12
(
2
):
1685
708
.
30.
Martínez
ME
,
Unkart
JT
,
Tao
L
,
Kroenke
CH
,
Schwab
R
,
Komenaka
I
, et al
.
Prognostic significance of marital status in breast cancer survival: a population-based study
.
PLoS One
.
2017
;
12
(
5
):
e0175515
.
31.
Huang
T-B
,
Zhou
G-C
,
Dong
C-P
,
Wang
L-P
,
Luan
Y
,
Ye
J-T
, et al
.
Marital status independently predicts prostate cancer survival in men who underwent radical prostatectomy: an analysis of 95,846 individuals
.
Oncol Lett
.
2018
;
15
(
4
):
4737
44
.
32.
Strohschein
L
.
Do men really benefit more from marriage than women
.
Am J Public Health
.
2016
;
106
(
9
):
e2
.
33.
Trachtenberg
L
,
Esplen
MJ
,
Toner
B
,
Piran
N
.
Gender socialization as a predictor of psychosocial well-being in young women with breast cancer
.
Curr Oncol
.
2022
;
29
(
11
):
8121
32
.
34.
Boquiren
VM
,
Esplen
MJ
,
Wong
J
,
Toner
B
,
Warner
E
.
Exploring the influence of gender-role socialization and objectified body consciousness on body image disturbance in breast cancer survivors
.
Psychooncology
.
2013
;
22
(
10
):
2177
85
.
35.
Perdikis
G
,
Fakhre
GP
,
Speed
EA
,
Griggs
R
.
The psychological effects of breast cancer and reconstruction: “A stroll down mammary lane”--A patient’s artistic journal
.
Ann Plast Surg
.
2011
;
67
(
1
):
2
5
.
36.
Hagedoorn
M
,
Buunk
BP
,
Kuijer
RG
,
Wobbes
T
,
Sanderman
R
.
Couples dealing with cancer: role and gender differences regarding psychological distress and quality of life
.
Psychooncology
.
2000
;
9
(
3
):
232
42
.
37.
Mahalik
JR
,
Burns
SM
,
Syzdek
M
.
Masculinity and perceived normative health behaviors as predictors of men’s health behaviors
.
Soc Sci Med
.
2007
;
64
(
11
):
2201
9
.
38.
Ullrich
A
,
Böttcher
HM
,
Bergelt
C
.
[Gender-related aspects of returning to work in cancer survivors. A systematic review]
.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz
.
2012
;
55
(
4
):
516
32
.
39.
Lim
J-W
,
Paek
M-S
,
Shon
E-J
.
Gender and role differences in couples’ communication during cancer survivorship
.
Cancer Nurs
.
2015
;
38
(
3
):
E51
60
.
40.
Yeung
NCY
,
Zhang
Y
,
Ji
L
,
Lu
G
,
Lu
Q
.
Guilt among husband caregivers of Chinese women with breast cancer: the roles of male gender-role norm, caregiving burden and coping processes
.
Eur J Cancer Care
.
2018
;
27
(
5
):
e12872
.
41.
Traa
MJ
,
De Vries
J
,
Bodenmann
G
,
Den Oudsten
BL
.
Dyadic coping and relationship functioning in couples coping with cancer: a systematic review
.
Br J Health Psychol
.
2015
;
20
(
1
):
85
114
.
42.
Rothausen
CS
,
Clausen
AM
,
Voltelen
B
,
Dieperink
KB
.
Protective buffering: nurses facilitating communication between adults with cancer and their adult family caregivers who overprotect one another-an integrative review
.
J Fam Nurs
.
2023
;
29
(
4
):
417
36
.
43.
Ussher
JM
,
Sandoval
M
.
Gender differences in the construction and experience of cancer care: the consequences of the gendered positioning of carers
.
Psychol Health
.
2008
;
23
(
8
):
945
63
.
44.
Hagedoorn
M
,
Kuijer
RG
,
Buunk
BP
,
DeJong
GM
,
Wobbes
T
,
Sanderman
R
.
Marital satisfaction in patients with cancer: does support from intimate partners benefit those who need it the most
.
Health Psychol
.
2000
;
19
(
3
):
274
82
.
45.
Cislaghi
B
,
Heise
L
.
Gender norms and social norms: differences, similarities and why they matter in prevention science
.
Sociol Health Illn
.
2020
;
42
(
2
):
407
22
.
46.
Rice
S
,
Oliffe
J
,
Seidler
Z
,
Borschmann
R
,
Pirkis
J
,
Reavley
N
, et al
.
Gender norms and the mental health of boys and young men
.
Lancet Public Health
.
2021
;
6
(
8
):
e541
2
.
47.
Coyne
E
,
Heynsbergh
N
,
Dieperink
KB
.
Acknowledging cancer as a family disease: a systematic review of family care in the cancer setting
.
Eur J Oncol Nurs
.
2020
;
49
:
101841
.
48.
Asiedu
C
,
McKinney
NS
,
Willis
AI
,
Lewis
FM
,
Virtue
S
,
Davey
A
.
Cancer and the family: variations by sex and race/ethnicity
.
Cancer Med
.
2024
;
13
(
2
):
e6969
.
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