You made it. You’ve endured the chemotherapy, the surgeries, the endless parade of pills and shots and shifting plans. You survived the nausea and fear. Your strength is returning, the last bruises are fading, and your hair has sprouted into life with the victorious resolution of spring petals pushing through the last snow. On the winning side of breast cancer, you probably feel more alive than you ever thought possible.
But for many women, that glory may be accompanied by new uncertainties. What happens now? What if my cancer returns?
The top priority after primary cancer treatments have finished is vigilant surveillance for any late-blooming metastasis. While this might sound like a permanent prescription for anxiety, take comfort; radiologic and lab testing methodologies that are used to monitor for early signs of cancer, in combination with low-level maintenance therapies, are very effective at staving off new tumor growth or detecting them at vulnerable early stages.
Here are some of the ways your doctor will continue to keep you safe after treatment is done:
Tumor Markers
All cancer cells produce chemical markers, signals that are detectable by blood testing. These tumor markers alert us to the presence of abnormal cell growth long before it is visible on imaging or manifesting in physical symptoms. Typically, your doctor will order them to be drawn every two to three months for the first year, depending on the type or extent of your breast cancer, then less frequently as years go by.
The three specific tumor markers are:
Tumor markers are used to detect any metastasis (spreading) of breast cancer cells to other parts of the body. Low levels of detection are sometimes considered expected (if not normal), and if they remain stable, may not be considered a sign of imminent danger. If tumor markers rise, this is an indication to your provider that new treatments may be necessary to prevent new cancers from progressing.
Imaging Studies
PET and CT radiologic exams can be performed starting twelve weeks after treatment has finished. These can be used to ensure that there are no hidden masses anywhere within the body. Because of the relative radiation exposure, however, these types of exams are performed sparingly.
Bone scans are also utilized if there is any complaint of bone pain or simply to ensure that bone metastasis has not occurred.
Maintenance Therapy
If your breast cancer is a more common estrogen-receptor type, low-level oral chemotherapy can be used to inhibit tumor growth for up to five years. Anastrozole and tamoxifen are the most commonly prescribed tumor-inhibiting drugs. Although they do produce minor side effects, such as nausea, dizziness, or early bone loss, these are very manageable. These medications can significantly reduce the odds of your breast cancer returning somewhere in the body.
The Importance of Self-Care
You fought the battle of your life to be here today. Make yourself and your happiness a priority. Once treatment is in the past, you should make extra effort to reduce stress, get plenty of rest, invest in exercise and good nutrition, and truly enjoy every moment that you earned back in life after breast cancer.