In South Florida, where heat shapes daily routines long before summer officially arrives, researchers at the University of Miami are uncovering a hidden burden: extreme heat is fundamentally altering how people with cancer manage their illness, navigate medical care, and live their lives.
A new study published in Environmental Research: Climate examined this intersection of climate stress and cancer care through in-depth interviews with 20 adults across 18 ZIP codes in South Florida. The research, led by Kilan Ashad-Bishop at Sylvester Comprehensive Cancer Center and Amy Clement from the Rosenstiel School of Marine, Atmospheric, and Earth Science, represents a rare interdisciplinary effort to understand how environmental conditions intersect with serious illness. Interviews were conducted in both English and Haitian Creole, capturing experiences across diverse communities and revealing how heat stress compounds existing health and financial vulnerabilities.
What the researchers discovered is sobering: heat touches nearly every part of cancer patients' routines. It determines when people leave their homes, whether they follow medical advice, how connected they feel socially, and how much money they must spend simply to stay safe and comfortable. Sylvester member Sophia George, senior author of the study and an associate professor in the Miller School's Department of Obstetrics, Gynecology and Reproductive Sciences, emphasized the importance of understanding how medicine, a person's environment, and lived experience intersect. "You can't understand it from just one discipline," George said. "Team science was essential for this work because of the environmental perspective, the cancer science and the clinical experience."
The adaptations participants described reveal a painful calculus. Some limited outdoor activity or planned essential errands during cooler hours. Others stayed indoors and relied heavily on air conditioning. Some delayed or even skipped medical visits to avoid heat exposure. Those already managing treatment side effects, fatigue, or financial strain found their already-narrowed choices shrinking further. Physical activity declined, social connections frayed, and essential errands were postponed or abandoned.
What makes this pattern particularly insidious is its incremental nature. Rather than triggering sudden health crises, heat strain works quietly through a series of small compromises. Ashad-Bishop captured the lived reality of this process: "They're weighing comfort against care, safety against necessity. Those decisions add up." For cancer patients already navigating the profound challenges of treatment and recovery, these cumulative trade-offs risk silently eroding long-term well-being—not through dramatic events, but through the steady accumulation of necessary sacrifices.
This research arrives at a critical moment. According to the U.S. Environmental Protection Agency, extreme heat refers to periods significantly hotter and more humid than average for a given place and time. As global temperatures continue to rise, creating longer heat seasons and more frequent extreme heat days, the challenges identified in South Florida—one of the nation's most heat-exposed regions—will increasingly affect cancer patients elsewhere.
The University of Miami's team-science approach offers a model for health systems grappling with these intersecting challenges. By bringing together atmospheric scientists, cancer specialists, nurses, and other disciplines, the research demonstrates that addressing the health impacts of climate change requires looking beyond any single field. For cancer patients already carrying an enormous burden, understanding how heat shapes their choices—and finding ways to support them—has become a matter of clinical necessity.