An attractive, healthy-appearing young woman came to my office the other day. "I've had a big operation, radiation therapy, and a year's worth of chemotherapy", she announced. "Congratulations," I said. "You look great. What can I do for you?" "Now what do I do?" she responded. "Go out and enjoy your life!" I said. "You've paid your price, new reap your rewards."
After more discussion it became apparent that this lady was now preparing herself to wait for her cancer to return. She was having trouble accepting her present good health because no one could assure her that her cancer wouldn't return someday in the future. She was now expecting to spend much of her present time and energy taking tests and waiting in doctors' offices so that she could be assured that she was as healthy as she felt.
The truth is, she has done all that she can to cure her cancer at this point. If she is not cured, there is no great advantage to discovering that fact early. If her cancer returns, treatment will be directed towards relief of problems. Cure will no longer be a realistic expectations. It, therefore, makes no sense to scan and x-ray her every few months. If she develop some sort of problem, then we will scan and x-ray. I generally tell my patients "If you feel good you are good. Enjoy your life."
As I have said before, it is very important to find original or primary cancer as early as possible. the earlier a new cancer is found, the better the chance for cure. Consequently, we have developed tests and equipment that enable us to detect abnormalities before they cause symptoms or problems.
Unfortunately, the benefits of finding recurrent cancer early are not so great. Our ability to treat recurrent cancer has not progressed as rapidly as our ability to find it. i have taken care of several patients who have been found to have recurrences that didn't bother them at all. Together we decided to do nothing unless and until the recurrence became a threat to them. One patient lived five years before we initiated treatment for the recurrence. That's five years of normal life before anything had to be done.
Treatment for recurrent cancer is called "palliatiion" and is directed at the relief of symptoms. It is difficult to improve a patient who feels good. In the field of cancer therapy we say "It's hard to palliate the asymptomatic patient."
My advice to people like this young lady is simple. You've done all you can to get rid of your cancer. It may well never come back. Walk away from it. Unlike heart attacks and strokes, cancer doesn't recur suddenly and take you away in the middle of the night. You will have plenty of time to deal with a recurrence if and when it occurs. So relax and enjoy life. If you feel good today you are good.