Background <p>Due to improved diagnostics and treatment, the number of long-term cancer survivors is rising. However, long-term physical, psychological, cognitive, and social sequelae often remain insufficiently addressed.</p> Objective <p>This article outlines the prevalence and spectrum of long-term psychosocial effects, summarizes evidence on effective interventions, and discusses structures and challenges of psycho-oncological follow-up care.</p> Materials and methods <p>Based on a&#xa0;narrative overview including epidemiological studies, guidelines, systematic reviews, and health services reports on the situation of long-term cancer survivors, the focus was placed on psychosocial aspects and the care situation in Germany.</p> Results <p>Long-term survivors show increased rates of somatic and mental comorbidities, fatigue, fear of progression, and affective disorders, as well as impairments in quality of life, work ability, and social participation. Specialized survivorship services are currently only selectively established. The updated German S3 guideline recommends continued psycho-oncological care across the trajectory.</p> Conclusion <p>Needs-based long-term follow-up care requires systematic screening, defined care pathways, multiprofessional survivorship models, and closer integration of oncological and primary care structures. Particular research requirements focus on individual trajectories, underserved groups, and the implementation and evaluation of innovative care models.</p>