How to Cope When Breast Cancer Returns
The lessons to be learned from Elizabeth Edwards -- very public battle with cancer recurrence.
How Cancer Recurs continued...
Current cancer research involves work to better individualize the prediction
for recurrence, based on a woman's gene profile. Freedman says this is
exciting, because more precise predictions will help doctors select the most
effective type of therapy, based on the cancer's tumor characteristic, to
When his patients are first diagnosed with breast cancer, Freedman tells
them it's going to be cured. "But after a recurrence," he says, "we say we'll
try to keep it in remission and prolong your life. We manage it more like a
chronic illness. In Mrs. Edwards' case, she knows she will always be living
with breast cancer now."
When Breast Cancer Returns: Emotional Fallout
Freedman says Edwards' news scared a lot of his patients. "Nobody wants to
hear about recurrence -- whether you're in treatment or you're out of treatment
and think you're out of the woods," he says. "They wake up with a backache, and
they think it's the cancer. They think they can't just have an ordinary
No matter how frightening the prospect, experts say starting treatment
quickly after the diagnosis of a recurrence is critical. Kaklamani says some of
her patients are bitter because their cancer spread after their first round of
treatment, and they are not willing to be treated again. "But the sooner
treatment starts, the better," she says. "We've proven that treatment not only
prolongs life but can improve the quality of life. They can live better."
Treatments include surgery, radiation therapy, hormone therapy, antibody
therapy, and pain medication. Kaklamani says 70% to 80% of breast cancers
respond to hormone therapy, so that is often the first-line treatment when the
patient is ER-positive.
"Because of the wide array of effective therapies, I'd say breast cancer has
the best prognosis of any cancer after recurrence," says Freedman. "We have
several hormone therapies, several chemotherapies, and several targeted
therapies. Women are managed with these treatments to prolong survival."
Edwards' own treatment regimen includes a daily chemotherapy pill and a
monthly intravenous treatment, which is a bone strengthener. She remains
active, and a New York Times article this summer reported that her cancer
hasn't hampered her daily life.
Survivor Earla Marshall says she subscribes to the same philosophy she sees
Edwards following: "Listen to your medical team's advice, take rest when you
need to, and otherwise get on [with] living, until your mind and body indicate
that you cannot," she says. "Every second that we are on this earth, we are
alive and we should embrace life as fully as we can."
When Breast Cancer Returns: Tips for Coping
Hearing her breast cancer has returned is every survivor's worst nightmare.
But, says Sandi Kafenbaum, LCSW, with the Adelphi N.Y. Statewide Breast Cancer
Hotline & Support Program, you can do a lot to manage the news and take
care of your health. Kafenbaum, who coordinates breast cancer support groups
and counseling, offers these tips: