Reaching the 5-year mark cancer-free

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In the big scheme of things, five years isn't much time. But for people diagnosed with cancer, five years is a kind of signpost that suggests whether they're on the road to recovery.

"It's a good benchmark and gives you a sense of someone's overall prognosis," said Dr. Jules Cohen, an oncologist and assistant professor of clinical medicine at Stony Brook University Cancer Center. "It is a surrogate for 10 years and 20 years and 30 years. Although it's not a perfect surrogate, it's a good approximation of long-term outcome for people."

In other words, making it to five years is a good indication -- but not a guarantee -- that a person will survive for years or decades longer.


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"It has tremendous emotional significance for patients, and it should," said Dr. Ken Gold, chief of hematology oncology at Good Samaritan Hospital in West Islip and co-director of cancer services for Catholic Health Services of Long Island.


POST-TREATMENT SIGNPOST

In general, doctors believe the five-year period begins after the main treatment is finished -- after the patient is done with surgery, chemotherapy, radiation or some combination of these treatments. "That's when the five-year clock begins ticking," Cohen said.

One major reason the five-year mark is so important is that many clinical trials, which test new treatments, use survival to five years as a benchmark. If the treatments are successful at that point, the studies have found, more patients live longer.

Also, the five-year period allows patients to see how they're faring compared with others with the same condition. Overall, for example, 80 percent of people with bladder cancer survive to the five-year mark, according to the Mayo Clinic.

However, Gold noted that it's important for patients to remember that different types of cancer progress in different ways. Some cancers grow fast while others grow slowly and wax and wane over time.

In some cases, being free of disease at five years doesn't mean a patient is cured, he said. Doctors also may be able to offer more precise survival figures based on such factors as whether a particular cancer was diagnosed in its early stages.

Life after treatment involves much more than waiting for that five-year benchmark, however.

For one thing, cancer patients often return to normal once they finish their treatments. As Cohen said, "You're yourself again." But he added that it really depends on the baseline -- the person's health before cancer. "Normal can be different if you're a 45-year-old woman with breast cancer or a 75-year-old smoker with lung cancer who may have been sick to begin with," he said.


THE NEW NORMAL

Also, some cancer survivors will face long-term side effects from their treatment, he said. Many breast cancer patients, for example, suffer from swelling at the sites of lymph node surgery, sexuality problems and chronic pain, he said.

Some people may need to continue taking medication after their cancer treatment. Cohen said that breast cancer patients, for example, may take drugs like tamoxifen for five years. "When they're finished, the patients feel like they're out of the danger zone," he said. "The cancer can recur at any point, but the chances get lower and lower."

It's important to note that women with breast cancer sometimes think they're not protected against the cancer anymore because they're no longer taking the medication. But, in fact, "the benefit of these drugs is durable," Cohen said. "It lowers their risk for the rest of their life."

Another change after cancer treatment is completed is that patients may see their oncologist less often as time goes by. "You might see them every three months and then maybe every six months," Cohen said. "Once you're five years out, you might see them yearly."

But can cancer patients bid

farewell to their oncologists for good at some point? Maybe. "It's not quite clear when you should stop seeing your oncologist," Cohen said.

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