After Cancer, remission, recovery, and long term care.

In this week’s series of posts, we focus on life after cancer treatment, including recovery, maintenance and remission.

Cancer survivors: Care for your body after treatment

After your cancer treatment, as a cancer survivor you’re eager to return to good health. But beyond your initial recovery, there are ways to improve your long-term health so that you can enjoy the years ahead as a cancer survivor.

The recommendations for cancer survivors are no different from the recommendations for anyone who wants to improve his or her health: Exercise, eat a balanced diet, maintain a healthy weight, avoid tobacco and limit the amount of alcohol you drink.

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Dr. Stegall’s comments: The “recovery phase” after intense cancer treatment is very important, but unfortunately it does not get enough attention. Many patients tell me that they were told by other doctors that it doesn’t matter what you do after treatment, just “enjoy your life.” I disagree. Cancer is a lifelong diagnosis, and we MUST remain vigilant. Continuing to eat an anti-cancer diet, exercising regularly, reducing stress, and getting plenty of sleep are all essential.


Recovery, remission and follow-up

If treatment is successful people may be told they are in remission, which can mean either that the disease has been significantly reduced (partial remission) or eliminated altogether (complete remission). The length of remission depends on individual circumstances but the longer people are in remission the less likely their disease is to relapse.

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Dr. Stegall’s comments: I do not like the word remission, or its close cousin, cure. These words imply that the cancer is gone, which is very misleading. When routine labs are normal and radiology images show no evidence of cancer, we should be excited about the great progress, but we must not ignore the fact that there are still some small cancer cells known as circulating tumor cells (CTCs) in the body. If these CTCs are not routinely measured and controlled, the chances of recurrence are much greater. I have patients in my office on a regular basis who did everything “right” – surgery, chemotherapy, and radiation – and were told that they were in remission or cured, only to have their cancer come back. How could this happen? Because the circulating tumor cells were ignored. Monitoring them tells us how we are doing in terms of the systemic burden of cancer and allows us to be proactive in our ongoing fight against cancer.


Remission: What Does It Mean?

If you’ve been diagnosed with cancer, you’re probably hoping to hear your doctor use the word “remission.” It marks a major turn in your care and long-term health. But it’s more complicated than simply being done with treatment.

There are two types of remission: Partial remission and Complete remission

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Dr. Stegall’s comments: If your oncologist tells you that you are in remission, ask him or her what you can do to best monitor your status and reduce your risk of recurrence. If he or she simply says, “There is nothing to do,” or offers a very vague response in terms of routine testing, I would recommend finding another doctor. There are many ways we can evaluate the body’s cancer status, and we must use at least a few of these to monitor patients. If we don’t, then we are passively waiting around for cancer to come back and that is unacceptable.

Breast Cancer Study Update

The study questions whether reliance on insufficiently-validated antibodies has led science down a dead-end path since the discovery of estrogen receptor beta (ESR2) in the

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