A couple days ago, I went in for the next in my series of 3-month check-ups. A few odd numbers still show up for the blood cells, but everything else looks OK. It’s been 15 months since the end of chemotherapy, just over a year since my last dose of radiation. So I “graduate” to check-ups every 6 months now, and return to the annual schedule for mammograms/MRI. (Frankly, I’d prefer to skip the mammogram, but the doc likes to see one.)
So why the switch to a new schedule? After all, cancer can come back any time it pleases.
The logic goes something like this: If it’s a supremely aggressive breast cancer, it will very likely come back during the first year after treatment. After that first year, the chance of recurrence drops a bit and, in the case of triple negative disease, the chance of recurrence drops precipitously after the third year. But as is typical of the confusion in the media when it comes to health information, I also read somewhere that the peak of recurrence for triple negative tumors is in the second and third years, so I don’t know what to believe. This is one of those moments when I just turn myself over to the recommendations of the folks who know more than I do. If the doc says don’t come back for 6 months, I’m not going to argue.
Listed below are bits of news I’ve collected about recent developments related to cancer and cancer patients in general:
- Lest we think too much of our American advances in medicine, to the exclusion of developments in other places, here is an article describing the use of something called the Mobetron, a type of linear accelerator, in Japan. This unit is used for intraoperative electron-beam radiation therapy (radiation delivered *during* surgery) and has been employed for patients with pancreatic cancer since 2006 and breast cancer since 2007. Its use in Japan was inspired by results from studies in Italy. This approach makes it possible to apply a single dose of radiation directly to the cancer site during surgery, allowing the patient to avoid the 6 weeks of standard postoperative treatment. Besides the obvious advantage of shortening treatment, such an approach means the surgeon can directly see the field to be radiated and there is less damage to surrounding tissues. This technique has crossed the ocean but is not widely available yet in the U.S. If you’re interested, you can see the unit in operation (and the shameless plug for the hospital it’s at) in this video.
- A couple of other recent studies serve well to dispel some of what are in fact myths of cancer treatment. The first group of researchers found that depression is no more prevalent in cancer patients than in the general population of primary care patients. The second set of investigators discovered that it may not be necessary to remove a large number of lymph nodes to assess the spread of breast cancer – a procedure called lymphectomy that can sometimes lead to problems with lymphedema, a painful swelling of the arm. They found that women who have only a few nodes removed for analysis have 5-year survival rates almost identical to those who have more nodes removed. I rather wish this study had come out a little sooner, but it might not have changed the picture for me after all. Extensive removal of nodes may still be necessary for those who have Stage 3 cancer. The piece of this puzzle yet to be explained is how a doctor then determines the stage of disease, since the number of lymph nodes involved is often what distinguishes, say, Stage 2 from Stage 3. I’m sure there’s more news to come on this front.
- A friend sent me a notice about ways to prevent thyroid cancer, the rates of which have been steadily increasing over the years, particularly in women. Some researchers suspect that this increase could be a consequence of the increased use of dental x-rays and mammograms. Few of us know that the apron the dentist puts on you for x-rays has a flap that goes up around your neck to protect the thyroid. There is also something called a “thyroid guard” for use during mammograms, but most technicians don’t use them unless you ask. You can find more information about these methods of protection at one of my favorite websites, the one that investigates Internet myths and legends – Snopes.com.