Bonnie Annis is a breast cancer survivor, diagnosed in 2014 with stage 2b invasive ductal carcinoma with metastasis to the lymph nodes. She is an avid photographer, freelance writer/blogger, wife, mother and grandmother.

Bonnie Annis

Bonnie Annis is a breast cancer survivor, diagnosed in 2014 with stage 2b invasive ductal carcinoma with metastasis to the lymph nodes.

On my last oncology visit, my doctor said something odd as we were saying goodbye. She said, “Next year, I’ll move you into the survivorship program.” I didn’t have time to ask any questions because she was headed out the door to her next patient. On the way home, I asked my husband why he thought I had to wait another year to be considered a survivor. I’d been living cancer free for eleven years! That’s when I started asking myself what it takes to be declared cancer free.

After doing some online research, I found out some doctors may consider a person "cancer-free" after he/she achieves five years in complete remission. That means all signs and symptoms of cancer have disappeared, and there's no detectable cancer in the body. But some cancers can recur even after five years, so it's not a guarantee of being completely cured.

The terms regarding being cancer free can be confusing. Complete Remission means cancer can no longer be detected through scans and other tests, and all symptoms have disappeared. No Evidence of Disease or (NED) if often used interchangeably with "complete remission," and it means that there are currently no signs of cancer.

Some doctors use the five-year mark as the gold standard. In many cases of cancer, if the disease hasn’t returned within five years of initial diagnosis, the chance of recurrence becomes very slim. But even after five years of being cancer free, some cancers can still come back. This is called a recurrence. Instead of remaining cancer free, some dormant cancer cells in the body become active again. They may come back to the original cancer location or in a different part of the body and even if they do, they’re still considered breast cancer.

Even after a long period of remission, doctors may not definitively declare someone "cured" because they can't be 100% certain that all cancer cells have been eliminated.

I’ve never heard the words, “You’re cancer free or you’re in complete remission.” I’ve never been blessed to hear the words, “There’s no evidence of disease.” I didn’t start waiting to hear the words until I was five years out from diagnosis because I had read about the five-mark milestone, but gee, 11 years of living with no evidence of disease, no signs or symptoms, shouldn’t I be a prime candidate for being dubbed cancer free? I think so.

Whether or not I ever hear the words, “You’re cancer free,” I’m claiming it to be true. I’ve done all the things to make sure my body is healthy post diagnosis, and I’ll continue to make my health a priority, but I’m not going to live my life stressing about an official diagnosis that declares me cancer free. In my heart I know it’s true. How do I know it? Well, it has a lot to do with my personal faith. Faith has carried me through every aspect of my cancer journey and I’m a firm believer that my trial is now over.

Cancer free, remission, no evidence of disease, all those professional terms sound good but I prefer to say I’ve been healed of an awful disease. I’m one of the lucky ones.

In the United States, a woman’s lifetime risk of being diagnosed with invasive breast cancer has increased since 1975. Then it was 1 in 11 women, today it’s 1 in 8. Older women are more likely to be diagnosed than younger women. Those are scary odds when you think about it. That’s why I’m doing everything in my power to make sure my daughters and granddaughters are proactive about their breast health. For those old enough to get mammograms, I remind them annually to do it. For the younger ones, I encourage their mothers to teach them how to do breast self-exams by the time they become teens. Knowing what your breasts feel like can help a young woman become familiar with her breasts and alert her to something that feels odd or different.

As breast cancer survivors, it’s our responsibility to celebrate each year of survivorship but it’s also our responsibility to share our knowledge with other women. By sharing our experiences, we can help breast cancer become less fearful to the undiagnosed and encourage the diagnosed to hold on to hope.

Eleven years with no cancer signs or symptoms – I’m claiming I’m cancer free and this year, on my cancerversary, July 9, I’m going to celebrate bigger than I ever have before. The doctor may not say I’m completely cancer free, but I think I am and I’m going to live like it. No one is going to rob me of that joy.

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Articles

Living cancer-free for eleven years, the author reflects on the complexities of being declared "cancer-free" or in "complete remission." Despite the absence of cancer signs or symptoms, the author emphasizes personal faith and proactive health measures over official medical declarations. The narrative underscores the importance of breast cancer awareness and education, particularly for younger generations. The author celebrates survivorship and encourages sharing experiences to reduce fear and inspire hope among those affected by breast cancer, while acknowledging the evolving nature of cancer diagnosis and recurrence.

After eleven 11 of survivorship, I’ve been waiting to hear the words, “You’re completely free of cancer! Go in peace,” but I’m wondering if it ever will happen. 

What Does It Take to Be Declared Cancer Free After Breast Cancer?

When I was a young child, I was afraid of the dark. As daylight dimmed and I knew bedtime was approaching, I'd begin to get nervous. I'd beg my mother to let me leave the closet light on so my room wouldn't be completely dark. She'd chide me and tell me I wasn't a baby, but after a few terror filled nights, she realized I was deathly afraid of the dark and allowed me to leave the light on in the closet if I only cracked the door. That gave me some comfort, but I always had to check under the bed before I climbed in and even though I shared a room with my sister, I was terrified that something would reach out and grab my ankle in the middle of the night. Sometimes, I feel like cancer is the monster under my bed now. Though I know, in my heart, it's not there, it sure feels like it might pop out and take hold of me again.

Yesterday, I went to the cancer treatment center for a bone scan. My oncologist ordered it to make sure all was well. It's been almost 11 years since I was diagnosed, but I still return for periodic tests. I'm thankful my doctor is keeping a watchful eye on me. Walking into the center after a year, I felt nervous. Though I wasn't there for treatment this time, the memories of all I'd been through over the years haunted me. The sights, the sounds, the smells of sickness were everywhere.

Living in fear is not fun. You'd think, after all these years of being cancer free I could accept the fact that I'm out of danger, but that's not the case. I know there could be a rogue cancer cell roaming through my body and one day, it could start growing. Next time, I might not be blessed to find it as early as I did the first one. I hope I never have to find out, but I may have to face that fear head on in the future.

It'd be great if surgery to remove cancer could completely eradicate it. It'd be even better if there was some sort of internal scanner that could prove beyond a shadow of a doubt that it was completely gone. PET scans, MRIs, CT scans and other tests do help, but I'm talking about a kind of internal high beam flashlight that is trained to look specifically for those deadly, wicked cells.

Not long ago, I needed blood work. The technician had a hard time finding my veins because they're so tiny and she was limited to using only one arm due to my lymphedema. She tried several times and after missing again and again, went to get a lighted ultrasound scanner. Within seconds she'd found a vein, and the needle was in. If we had a cancer cell finder like that, it'd be great, but it would have to penetrate deep through tissues and muscles. I'd like it if it could work from the inside out, almost like radioactive dye works when having a thyroid scan.

I imagine many have felt the overwhelming fear of a cancer recurrence like have. That fear has lessened over the years, but it's not completely gone. Some may think it silly to fear a possibility, but once you've experienced cancer, you don't ever want to meet that monster again.

Though I'm grown now, I keep a nightlight on in my bathroom at night. It helps keep me from stubbing my toe or tripping over something. Sometimes, when I think back to my childhood, the feelings of those nighttime fears frighten me. It probably wouldn't have been so bad if my mother had talked with me and tried to soothe my fears or if she'd brought in a homemade bottle of colored water labeled "Monster Spray." It would have been great if she'd knelt with me and held the flashlight while I looked beneath the bed and fired away with the magic spray. At least then I would have felt like I had some sort of weapon to combat the evil. But cancer doesn't flee as quickly. Maybe that's why it scares me so.

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The narrative explores the persistent fear of cancer recurrence, likening it to childhood fears of the dark. Despite being cancer-free for over a decade, the author remains anxious about potential relapse, highlighting the psychological impact of cancer survival. The desire for a definitive diagnostic tool to detect cancer cells is expressed, reflecting the ongoing anxiety and uncertainty faced by survivors. The story underscores the need for emotional support and coping mechanisms to manage the fear of recurrence, drawing parallels between childhood fears and the enduring dread of cancer.

Fear is a powerful enemy of the mind but there’s another word that has the same power. That word is a six letter one, cancer. 

My Imaginary Fear of Cancer Recurrence

Americans like to eat and it’s no wonder that they do. Every single time we turn on the television, commercials prod us to try the newest food products. Many advertisements found on cable or streaming services focus on unhealthy foods like sweets and fast foods. Those tantalizing marketing ads make us salivate.

During the summer, I start to become more aware of the excess weight I’m carrying. Being physically active is more challenging when the temperatures soar and every extra pound seems heavier than normal.

Today, I was helping my husband with some yard work. It was 90 degrees outside, I was “sweating like a pig” and felt yucky. Over the course of a few years, as I’ve gotten older, I’ve become more sedentary, and the pounds have slowly crept on. I hadn’t realized it during the cooler months but today was a different story. I knew I had to do something about it. Not only was I concerned about feeling better, but I was also concerned about the possibility of excess weight contributing to a recurrence of breast cancer. After 11 years of living cancer free, I never want to risk having it come back into my life.

I remember reading several medical articles about studies done on postmenopausal women, particularly those who were overweight or obese. Since I fell into the postmenopausal category and I’d packed on a few pounds, I paid more attention. Studies revealed that when those factors were combined with cancers fed by estrogen (ER+), it got even more dicey. Apparently excess body fat led to more production of the hormone estrogen and that could feed cancer cells, causing them to grow.

What could I do to give myself better odds? It wasn’t hard to figure out. I needed to work on my diet and exercise. If I cut out processed foods and sweets, focusing more on healthy options like lean meats, fresh vegetables and fruits, I’d probably start to feel better. Coupling that with daily exercise, like walking, I’d burn unnecessary calories.

Women don’t like to talk about their weight but during the summer months, we often become more conscious of how we look. When it’s time to pull out the bathing suits and shorts, there’s not a lot of leeway for camouflaging those “jelly rolls.”

For many years, physicians have encouraged patients to eat healthily, exercise often and maintain a healthy weight; however, attempting to do those things isn’t always as easy as one may think. Will power requires determination but if controlling what goes in our bodies can help keep cancer at bay, shouldn’t we want to do it?

No one wants to face a cancer recurrence, but as a breast cancer survivor, I know it’s a real possibility if I don’t stay on top of things.

A recurrence of breast cancer can occur at any time to someone, but studies indicate patients who are postmenopausal and carry excess weight may be at a higher risk. If you fall into that category, like I do, I hope you’ll choose to do something about it before it’s too late. Health is really such a valuable asset. Ask any cancer survivor, we know.

Maintaining a healthy lifestyle is crucial for postmenopausal women, particularly those who are overweight, to reduce the risk of breast cancer recurrence. Excess body fat can increase estrogen production, potentially fueling estrogen receptor-positive (ER+) cancer growth. Adopting a balanced diet and regular exercise can help manage weight and improve overall health. Despite the challenges of willpower, the benefits of controlling diet and physical activity are significant in preventing cancer recurrence. Awareness of one's health, especially during summer, can motivate positive lifestyle changes.

After years of survivorship, I’m realizing that shedding extra pounds may do more than improve comfort — it could reduce my risk of recurrence.

Could Shedding a Few Pounds Prevent a Breast Cancer Recurrence? 

It’s been almost 11 years since I had surgery to remove breast cancer. Some days feel like it was a lifetime ago, and others feel like it was just yesterday. It’s taken time to accept my body the way it is now. The scars are no longer fresh and raw. They’re still visible but have almost faded into the same shade as the skin on my chest wall. I’ve worked hard to look at them as evidence of survival, but sometimes they still cause me pain.

Recently, on a visit to the emergency room following unrelated cancer surgery, I had to remove my shirt so staff could perform an EKG. At that time, the nurse on call was a male. I felt awkward removing my shirt in front of him, even though my husband was with me and felt like I needed to give him a heads up as to what he’d see. In the past, nurses at other medical visits have expressed disgust, sadness, or shock when I’ve had to remove my shirt. After seeing their reactions, I decided it would always be best to warn someone before freaking them out with my breastlessness.

The guy did his best to be professional, but I watched his face. I could tell he hadn’t seen a breastless woman before, and it was making him uncomfortable. I gave him a nutshell version of my cancer story while he hooked the electrodes to my body, and he seemed to relax, but after leaving the room, I heard him talking with another staff member in the hall. He told that person he’d just witnessed something odd.

The other staff member asked what he was talking about, and he said, “A woman with no boobs.” Then they started laughing. Tears welled in my eyes, and my husband reached to hold my hand. When I returned home from that ER visit, I was sent a patient questionnaire by the hospital asking me to rate the visit. They had a place for comments after the survey questions were complete, and I gave them details about what had happened to me. I hope they reprimanded the staff member. I’d noticed his name on his hospital ID and had made sure to include it in my comments. That experience was extremely unprofessional and insensitive.

Then, on Mother’s Day, my son came to visit. He has an odd sense of humor and seems to find joy in shocking others with it. We were talking after lunch, and he said, “Hey, look at this TikTok video.” He held his phone out to me, and I saw a person filming a topless, breastless woman dancing. As the camera zoomed in on her, I could see familiar scars. She’d had a double mastectomy, like me. She was swaying to some soft jazz music. My son was laughing and said, “You could do that!” I was taken aback. I know he meant it to be funny and lighthearted, but I felt deeply wounded. I didn’t like feeling like I was a freak, something to be made fun of, and especially by one of my own children.

My oldest daughter sent me a GIF last night. It was a white bra filled with bright pink petunias. Someone had hung it on a garden wall. She texted, “Hey, Mom, you could do something like this with all of your old bras.” At first, I didn’t think anything about it. She knows I enjoy crafting and probably thought I’d find it funny, but I didn’t. Once again, my feelings were hurt, and I wondered how it was so easy for people to laugh and joke about a person losing part of their body.

Maybe I’m making a mountain out of a molehill, but I don’t think so. I’m not an overly sensitive person. I’ve done my best to roll with the punches through all facets of my cancer journey, but sometimes, it’s hard.

I’ve even thought perhaps something was seriously wrong with me. Maybe I need to see a therapist to discuss unresolved issues from having both breasts removed. Shouldn’t I be at peace with my decision now? How much longer will little things like this affect me?

As I try to self-analyze, I realize I miss my breasts. It sounds odd to say they were part of who I was, but it’s true. I felt whole with them. I don’t feel whole without them.

Summer is here, and it’s going to be very hot. We usually go to the beach and, while there, do some swimming. It’s gotten to the point where I hate summer. Not only because I’m flat-chested, but because swim prostheses never stay put in the special swimsuit I bought for women with mastectomies.

I do my best to camouflage my chest with pretty patterns or shirts with pockets, but still, I feel like people notice when I don’t wear prostheses. Wearing them in the summer is a challenge. The silicone ones are heavy and hot against my skin, and camisoles with built-in breast forms aren’t much better because it’s like wearing 2 shirts instead of one.

I’m not trying to complain, but it would be nice if people were more sensitive to those of us who’ve had to have our breasts removed. And yes, I could have chosen reconstruction and may not have dealt with any of these issues, but I didn’t want to go through another painful surgery.

When I was growing up, my mother used to tell me, “If you can’t say something nice, don’t say anything at all.” That euphemism has stuck with me all these years. I’m sure some people don’t mean to be insensitive toward those who’ve experienced breast cancer; it would be nice if they’d be more understanding. Perhaps if they’d try to imagine how it would feel if the “shoe were on the other foot,” they’d listen more and speak less.

Mastectomies do more than disfigure the body; they wound the spirit, too. I wish doctors would prepare patients for that, but sadly, they don’t.

The narrative reflects on the emotional and psychological challenges faced by a breast cancer survivor post-mastectomy. Despite the passage of time, the individual grapples with societal insensitivity and personal discomfort, particularly in medical settings and interactions with family. The story highlights the enduring impact of mastectomy on self-image and the need for greater empathy and understanding from others. It underscores the importance of preparing patients for the emotional aftermath of such surgeries, advocating for sensitivity and awareness in both personal and professional environments.

Breast cancer surgery can disfigure the body in some way, and often the scars are more than skin deep, which may worsen by the actions of others.

Bonnie Annis

What Does It Take to Be Declared Cancer Free After Breast Cancer?

My Imaginary Fear of Cancer Recurrence

Could Shedding a Few Pounds Prevent a Breast Cancer Recurrence?

Dealing with Insensitivity After Breast Cancer Surgery

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