Cancer survivorship is often described as the moment treatment ends, but for many people, the psychological effects of cancer continue long after surgery, chemotherapy or radiation. Anxiety, depression, isolation, changing relationships and uncertainty about the future can become persistent parts of life after treatment. Now, research from Drexel University and Memorial Sloan Kettering Cancer Center suggests that songwriting may offer more than emotional relief: it may help survivors identify and communicate the deeper personal and social challenges driving their anxiety.
The findings come from a qualitative analysis of 26 original songs written by adult cancer survivors during the Music Therapy Versus Cognitive Behavioral Therapy for Cancer-related Anxiety, or MELODY, trial. The study, led by Sarah Biedka, a PhD candidate in Drexel’s Music, Creativity and Wellness Lab, examined the lyrics, recordings and songwriting materials produced during music therapy sessions. Published in the Journal of Cancer Survivorship, the research found that participants used music to express concerns extending well beyond anxiety symptoms, including disrupted identities, strained relationships, difficulty prioritizing self-care and the search for meaning after cancer.
The songs were created as part of a larger clinical trial involving 300 cancer survivors experiencing anxiety. Participants received one of two telehealth interventions: cognitive behavioral therapy, widely regarded as the standard psychological treatment for anxiety, or music therapy delivered by credentialed music therapists. In the music therapy sessions, participants engaged in structured musical activities and wrote songs collaboratively with a therapist. The MELODY trial reported that music therapy helped reduce cancer-related anxiety, while the new analysis explored what participants were actually trying to process through their creative work.
According to the researchers, songwriting revealed a network of challenges that conventional symptom-based assessments can miss. Several participants described a conflict between responding to their own needs and maintaining stability in their relationships. After cancer, survivors may need rest, emotional support, new boundaries or changes in family roles, yet they may hesitate to ask for these things because they fear burdening loved ones. The resulting tension can produce isolation and resentment. In some songs, participants portrayed themselves as choosing the comfort of the existing relationship over their own recovery, even when that choice left important needs unaddressed.
Music may be particularly useful for exploring these conflicts because it combines verbal and nonverbal forms of communication. A lyric can state a fear directly, while melody, rhythm, harmony and vocal delivery can convey uncertainty, anger, grief or hope that may be difficult to describe in ordinary conversation. The researchers analyzed not only the written lyrics but also song recordings, brainstorming notes and notes from meetings between participants and therapists. This broader approach helped them interpret metaphors and musical decisions within the context of each survivor’s experience rather than treating the words as isolated text.
The structure of a song can also function as a psychological organizing system. Participants may place related thoughts in a verse, return repeatedly to a central concern in the chorus or introduce a contradiction through a bridge. In therapeutic terms, that structure can make conflicting experiences visible without forcing a person to choose one interpretation. A survivor can feel grateful to be alive and angry about what cancer has taken away; hopeful about the future and frightened by medical uncertainty; deeply connected to family and simultaneously lonely. By arranging these experiences into a coherent musical form, songwriting may help participants recognize patterns in their emotional lives.
The process also appeared to strengthen agency and identity. Participants reported feelings of accomplishment, pride and satisfaction after completing their songs. Creating a finished work gave them ownership over an experience that had often made them feel controlled by medical procedures, treatment schedules and unpredictable symptoms. Some described feeling seen and heard through collaborative songwriting. The researchers suggest that this response may be important because cancer can disrupt a person’s sense of identity, shifting attention from professional, family or creative roles toward the status of “patient.” Making an original song can provide a concrete way to reclaim authorship of one’s story.
Sharing the songs created another route for difficult communication. Survivors who might avoid a direct conversation with a partner, friend or family member could use the song as an emotional intermediary. Instead of explaining every feeling in real time, they could present a finished piece that communicated several layers of experience at once. The researchers noted that this may be especially relevant for people who fear being misunderstood, rejected or perceived as a burden. Music does not eliminate the need for conversation, but it can create a safer starting point for conversations that might otherwise never happen.
A related qualitative study led by Drexel professor Joke Bradt, published in the European Journal of Integrative Medicine, found that participants viewed music therapy as useful not only for managing moments of acute anxiety but also for engaging with the personal, relational and societal experiences that shaped their distress. Interviews indicated that participants valued music-based strategies they could carry into everyday life, including techniques applicable in different settings. Together, the studies suggest that anxiety during survivorship may not be merely an episodic symptom to suppress. It may also be a signal connected to unresolved grief, altered relationships, changing priorities and existential questions about the future.
The researchers emphasize that music therapy is not being presented as a replacement for cognitive behavioral therapy or other established mental health care. Cognitive behavioral therapy remains a first-line treatment for anxiety management, and further studies are needed to determine how music therapy can be implemented, for whom it works best and whether it offers economic advantages. Nevertheless, the MELODY findings point to a potentially powerful addition to comprehensive cancer survivorship care. By helping survivors reduce anxiety while also examining the experiences beneath it, songwriting may turn private distress into something recognizable, shareable and actionable. The team hopes the work will encourage healthcare providers and decision-makers to treat creative therapies as legitimate components of long-term cancer care rather than optional extras.
Subject of Research: Music therapy, songwriting and mental health challenges among adult cancer survivors.
Article Title: “This is my voice; this is my story”: a thematic analysis of needs and challenges expressed in songs by adult cancer survivors.
News Publication Date: 7-Jul-2026.
Web References: https://link.springer.com/article/10.1007/s11764-026-02071-9#Abs1; https://www.mskcc.org/cancer-care/clinical-trials/21-516; https://www.sciencedirect.com/science/article/pii/S1876382026001034?via%3Dihub
References: Journal of Cancer Survivorship, DOI: 10.1007/s11764-026-02071-9; European Journal of Integrative Medicine; Journal of Clinical Oncology, DOI: 10.1200/JCO-25-00726.
Keywords: Cancer survivorship, music therapy, songwriting, anxiety, mental health, cognitive behavioral therapy, psychotherapy, oncology, creativity, cancer patients.
