‘When it comes to heat, I retreat’: heat impacts and adaptation practices among people with cancer

Abstract Across the US, increasingly prevalent heat extremes pose diverse threats to population health and well-being. Due to sensitivities from age-related declines in thermoregulation, elevated prevalence of comorbidities, drug-induced dehydration and fatigue, as well as decreased disposable income, people with cancer are recognized as particularly susceptible to heat impacts. Yet, little empirical research has focused on this population. Our objective was to understand heat impacts, coping mechanisms, and adaptation practices among people with cancer. This qualitative study used semi-structured interviews of adults with a history of cancer in South Florida. Between May 2024 and January 2025, a total of 20 participants across 18 unique zip codes were interviewed, and data were analyzed using rapid qualitative methodology. Four key themes reflected ongoing challenges related to how people with cancer experience and adapt to heat in the region: (1) heat interacts with health status to adversely affect quality of life among people with cancer, (2) increased cooling needs result in significant lifestyle adjustments, (3) patient-provider communications are underutilized opportunities to discuss heat risks and heat-responsive health-promoting behaviors, and (4) social support facilitates heat adaptation. Our findings indicate that heat exposure leads to prominent health impacts among people with cancer, as well as a prioritization of access to cooling despite financial and social consequences. This need to stay cool often decreased quality of life due to social withdrawal, but quality of life impacts were mitigated by social support. Our findings indicate that heat exposure may differentially affect people with preexisting conditions such as cancer, leading to social withdrawal and maladaptive behaviors, which indicates a need for heat adaptation policy tools to be tailored to the unique needs of medically vulnerable populations. Future research should seek to further our understanding of behavioral changes among people with chronic disease in response to heat exposure, specifically across regions with chronic heat and humidity.