Medicare patients who underwent colon or lung cancer surgery at hospitals that eventually closed experienced significantly worse outcomes compared to those treated at stable facilities. The analysis of 2008-2019 data revealed higher 90-day mortality rates and increased complication rates among patients whose surgical hospitals subsequently shuttered operations. This retrospective study represents the first systematic examination of how hospital closures affect cancer surgical outcomes, revealing a previously unmeasured dimension of healthcare access inequality. The findings suggest that hospitals destined for closure may already be experiencing quality deterioration before their official shutdown, possibly due to financial stress, staffing challenges, or infrastructure decay. For cancer patients, this creates a troubling scenario where those most vulnerable to poor outcomes—often rural or underserved populations—receive care at the most precarious institutions. The research has immediate policy implications for hospital oversight and cancer care planning. Rural hospital closures have accelerated in recent years, making this pattern particularly concerning for future cancer patients. The study also highlights the need for early warning systems that could identify at-risk hospitals and potentially redirect complex surgical cases to more stable facilities before quality deteriorates.