What is "Late Recurrence" and How to Prevent It

As a breast cancer survivor, it is no secret that you’ve fought hard. But unfortunately, there’s no guarantee that the battle is over. Recurrence is a scary thought, and even after 5 years, the cancer could come back. For most estrogen receptor-positive (ER+) patients, prognosis is very good.

However, for women who do experience a recurrence, about half of the time, this will occur after 5 years.

Though nothing is guaranteed, there are some measures you can take to help prevent late recurrence. In addition to following your treatment plan, there are some changes that you can make to reduce your risk of recurrence and help you get through the next chapter in your life — healthy and happy.

1.  Follow your treatment plan.

The first step is to follow your treatment plan.

If you’ve just completed initial treatment, one of the best ways to prevent early and late recurrence is to be consistent with your anti-estrogen therapy.  It is not uncommon for women to forget or decide to stop anti-estrogen therapy because of the side effects. But if your doctor has put you on a 5 year treatment plan, it’s really important to take your medication regularly.

For some, continuing anti-estrogen therapy after the first 5 years can significantly reduce the risk of recurrence. Studies have shown that about 3 to 5% of women with ER-positive breast cancer benefit from extending their treatment to ten years.

If you’re an ER-positive survivor coming close to 5 years of treatment, you may be wondering if you fall in that 3-5% that may benefit from extending anti-estrogen therapy beyond year 5. The good news is there’s more information available now than ever before.

To learn if you might benefit from extending anti-estrogen therapy beyond 5 years, ask your doctor about Breast Cancer Index – a test that uses your initial tumor sample to help you and your doctor understand your personal risk of late recurrence and your likelihood of benefit from extended anti-estrogen treatment.

2.  Prioritize your mental health

While there’s no direct link to stress increasing risks of cancer, stress can encourage unhealthy habits like smoking and drinking that directly impact your physical health, and reduce your overall quality of life.  So finding ways to manage stress and anxiety following your breast cancer treatment is also important.

When your initial treatment is over, cancer doesn’t need to control your life anymore. Give yourself time to prioritize your mental and emotional health. Find hobbies and passions that help you relax, and discover ways to feel like yourself again. Enjoy time with family and friends, and make yourself a priority.

Lots of women find that keeping a journal, physical activity, and other creative outlets can help them recover from the stress of treatment. Others take up yoga, meditation, or join a support group to connect with other survivors. You have lots of options, it’s just a matter of what works best for you.

3.  Eat nutrient-rich, healthy foods

Adjusting your diet to include lots of fruits and vegetable, whole-grain fibers, and fish, is a great way to maintain a healthy weight, and make sure your body gets the nutrition it needs.

Avoid processed foods, reduce the amount of red meats you eat, and cut back on saturated and trans fats. Instead, choose organic options, eat poultry and beans for protein, and incorporate healthy fats like olive oil, nuts, and avocados into your meals.

If you haven’t already, cutting back your alcohol consumption to less than one drink a day is recommended. Alcohol can increase estrogen levels in your blood, and lower your folic acid levels, which are important in repairing and copying DNA.

To gain more insight on your dietary needs, speak to your doctor to help you decide what foods you should eat to fuel your body and stay healthy.

4.  Stay active

Physical activity is one of the best ways to stay in shape after surviving breast cancer. Incorporating something as simple as walking for 3 or more hours a week can help reduce the risk of death and mortality. And the benefits of exercise aren’t just physical. There are so many ways that staying active can help you recover from the emotional and psychological strain of breast cancer. It can relieve stress, improve body image, maintain bone health, and more.

So next time you’re out and about, take the stairs, bike to your destination, take a short walk on your lunch break. Join a sports team, go hiking, or sign up for a fitness class. There are so many ways to get moving in a way that’s enjoyable and fits your lifestyle!

5.  Maintain a healthy weight

Diet and exercise may help to prevent recurrence because they’ll help you maintain a healthy weight.

As a survivor, it’s very important to consider your BMI (or body mass index) to help prevent recurrence.

Weight is such a significant factor in recurrence because of the way fat cells work in a woman’s body. Fat cells produce estrogen — and increased estrogen levels can directly impact ER-positive survivors. In fact, women who are overweight are at an increased risk for recurrence.

There’s always time to adopt new healthy life choices, so if you’re a survivor who is overweight, work with your doctor to come up with appropriate goals and a weight loss plan that will help you reduce your risk of recurrence.

Conclusion

Whether you just finished your initial treatment, or you’re further along and are wondering what to do after the first 5 years of survivorship, these tips will help you live a healthy life and discover ways to prevent late recurrence.

Resources:

http://www.breastcancer.org/research-news/20080813

https://docs.google.com/a/wirebuzz.com/document/d/1OyWuvyEm4XmDIMfTfa1hhlrCDeBS9QER0XulNHli9I8/edit?usp=sharing

http://www.medscape.com/viewarticle/812513

http://www.hopkinsmedicine.org/breast_center/treatments_services/survivor_care/reducing_recurrence.html

http://www.breastcancer.org/symptoms/types/recur_metast

http://www.prevention.com/health/health-concerns/breast-cancer-new-treatments-prevent-cancer-recurrence

http://www.cancer.org/treatment/survivorshipduringandaftertreatment/understandingrecurrence/can-i-do-anything-to-prevent-cancer-recurrence

http://www.cnn.com/2013/10/18/health/food-breast-cancer-survivors/

http://www.answersbeyond5.com/understanding-recurrence

http://www.drdeborahmd.com/preventing-recurrent-breast-cancer#hafull

This is a blog post by Nancy Evans.