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    How to Cope When Breast Cancer Returns

    The lessons to be learned from Elizabeth Edwards -- very public battle with cancer recurrence.

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    Ros Innerfield, 77, another survivor who has recurrent breast cancer, says she is glad to see Edwards "show that you can talk about [your health problems] and then get on with your life. It's not something to shove in a closet that you've had a recurrence." Innerfield, who lives in Oceanside, N.Y., on Long Island, says she's noticed Edwards has become more outspoken in her husband's campaign over the last several months, which she finds inspiring. "I think it shows that this difficult problem in her life has made her stronger and more purposeful in what she believes in."

    In a televised 60 Minutes interview the week after her announcement, Edwards, a lawyer until she retired in 1996, told Katie Couric that dying with cancer concerns her less than living with cancer. "Concentrate on the things that matter to you," she said. "We're all going to die. And I pretty much know what I'm going to die of now. But I do want to live as full and normal a life as I can from this point on."

    How Cancer Recurs

    When oncologists talk about breast cancer recurrence, they refer to two different types: local, which recurs in the breast; and distant, or metastatic, which recurs elsewhere in the body, such as in the bones, brain, liver, or lungs. Recurrence is caused by cancer cells left behind during primary surgery, even though they may not show up on tests. Edwards' cancer is distant, since it has spread to her bones.

    Breast cancer may seem to have the highest rate of recurrence because breast cancer itself is the most frequently diagnosed cancer in women in the United States, except for skin cancer. Although every cancer is different (and largely dependent on the cancer's stage), lung, pancreatic, and ovarian cancer all recur more often than breast cancer. Freedman says breast cancer recurs in about 20% of survivors, compared to roughly 70% of women with ovarian cancer (which is usually detected at later stages). And he says death rates from breast cancer are actually decreasing, thanks to better and earlier detection and improved treatment.

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