COLUMBUS, Ohio-Hearing the words, “You have cancer,” is immediately upsetting. “That distress can echo through the years, negatively affecting a person’s quality of life [QOL] long after the initial diagnosis of cancer,” said Betty R. Ferrell, PhD, RN, research scientist, City of Hope National Medical Center. She spoke at a conference on cancer survi-vorship sponsored by the James Cancer Hospital and Solove Research Institute at Ohio State University. Indeed, she said, in a survey of cancer survivors, distress over initial diagnosis was ranked as the single most negative influence on quality of life, worse than fear of recurrent cancer, fear of cancer spreading, or physical symptoms like fatigue.