Whether your treatment has ended or you’re on long-term hormone or drug therapy, you may want to turn your attention to regaining your health, maintaining remission, and creating a body that is less supportive of cancer.
This may be a time when you feel anxiety around follow-up visits and testing, and perhaps fear that your cancer may recur. Taking charge of your health by blending anticancer healing practices and complementary therapies can empower you as you move in and through the challenges of living with cancer.
“A survivor is a person who lived through hardship or disaster. A thriver is more than that. It is someone who not only goes through an exceptionally positive or threatening life event, but shows subsequent growth because of the experience.” 1 Mangelsdorf J, Eid M. What makes a thriver? Unifying the concepts of posttraumatic and postecstatic growth. Frontiers in Psychology. 2015 Jun 23;6:813.
In addition to everything within At any time during your breast cancer experience › you may consider the practices and therapies listed here. They promote both surviving and thriving, including reducing your risk of relapse or recurrence, as you live the rest of your life.
These practices and therapies have at least modest evidence for the medical benefits listed. We add to this list as we complete new reviews of practices and therapies.
Several imbalances in your body terrain the internal conditions of your body, including nutritional status, fitness, blood sugar balance, hormone balance, inflammation, and more can make your body more susceptible to infection, slower to heal wounds, and/or more supportive of cancer. Chronic inflammation, high blood sugar and insulin resistance, obesity, and imbalanced stress chemistry may be particularly important to balance in relation to surgery, wound healing, and reducing recurrence risk.
When you have finished treatment, discuss and develop a survivorship plan with your cancer treatment team. Your survivorship plan includes instructions and a schedule for follow-up visits, plus testing and guidance on lifestyle and other self-care practices to help you recover and prevent recurrence. The type of testing and monitoring done to assess your response to treatment and pick up on recurrence depend on your specific cancer, treatment, and risk for recurrence.
You need to find a balance in the type and frequency of monitoring for breast cancer recurrence. Talk with your oncologist about your risk of recurrence and the type and frequency of monitoring best for you. Based on your risk, ask these questions:
Valid and reliable tests to pick up on recurrence early are under development. Blood tests such as circulating tumor DNA (ctDNA) and circulating tumor cell testing (CTC) have generated a lot of excitement, but they’re not yet ready for routine clinical use. According to CancerChoices advisor and breast cancer medical advocate Gwendolyn Stritter, MD, two fairly well-validated ctDNA tests, Guardant 360 and FoundationOne Liquid, are used to monitor treatment response in metastatic breast cancer. She suspects that within the next couple of years these tests may be validated for use in the post-primary/adjuvant, NED (no evidence of disease) setting as a very early warning of impending recurrence. CancerChoices is monitoring this situation and will update this page when new developments are announced.
Meanwhile, some women with no evidence of disease but at high risk of recurrence have requested ctDNA testing, understanding that insurance is not likely to pay for the tests. Guardant 360 will accept samples only in the case of metastatic breast cancer. Foundation Medicine’s ctDNA test costs about $5800, and—except for metastatic disease—insurance usually won’t cover the costs. Fortunately, Foundation Medicine, and perhaps other companies, do not charge the patient if the test does not reveal any ctDNA. Further, Foundation Medicine and other companies offer financial aid and discount programs in some cases.
Surveillance tools currently employed with those at increased risk of recurrence are listed on BreastCancer.org’s site.