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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.

    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 prevent recurrence.

    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 backache anymore."

    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."

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