With Cancer in Remission, What Is the New Normal for Patients?

What is life like for someone after cancer?

“Often it’s a series of physical adjustments,” Dr. Kevin Billingsley, surgical oncologist and chief medical officer at Yale Cancer Center and Smilow Cancer Hospital in New Haven, Connecticut, told CURE. “It takes weeks to months to recover from the physical rigors, often of a combination of chemotherapy and surgery.”

Even young, healthy people will need to rebuild themselves, Billingsley said, and this is often via a program that involves exercise under the guidance of a trainer or physical therapist, as well as some nutritional consultation.

“It can take longer than people expect,” Billingsley said. “There [are] also the emotional adjustments of getting back into the normal flow of life and dealing with the uncertainty that [accompanies] a cancer diagnosis... This is because even when treatments are highly successful, people [may] live with the uncertainty that cancer may return at some point, which can be quite stressful.”

‘It Takes Time to Adjust’

“Remission” is something of a nonspecific term, Billingsley explained. “It is generally applied to individuals who have undergone cancer treatment, either with surgery, chemotherapy, radiation, biologic therapies or some combination of therapies, and their cancer is no longer detectable. It’s not evident on physical examination, X-rays, CT scans or other traditional detection methods,” he said. “It, unfortunately, does not mean that the cancer is completely eradicated and will not return at some point, however.”

Frank J. Penedo, who has a doctorate in clinical psychology, told CURE about what is commonly referred to as the “the survivorship care period.” Penedo is center associate director, cancer survivorship and translational behavioral sciences; director, cancer survivorship and supportive care; and director, Biopsychosocial Mechanisms and Health Outcomes Lab, at Sylvester Comprehensive Cancer Center in Miami.

We have an expanding repertoire of very active treatments that really enhance our capability to cure or manage cancer for extended periods of time. — Dr. Kevin Billingsley

“The [National Cancer Institute] defines a cancer survivor as somebody from the day of diagnosis through the balance of their life,” Penedo said. “Survivorship care is the care that a person is receiving in addition to their medical treatment post completion of their primary treatments. In that survivorship care, it’s really critical that the patient remains very involved with their care team for a variety of reasons.”

Follow-up care is really important, particularly for a young person with cancer, Billingsley said. “If there is indication of recurrent cancer or recurrent disease, we would want to get them back into some kind of treatment program, and that could be any number of treatments, but it’s critically important that people maintain a relationship with their oncologist as well as undergo a well-defined set of follow-up examinations, which are usually a combination of often blood tests as well as imaging studies,” Billingsley said.

Regarding cancer survivorship, the space is in what Billingsley described as a very exciting time in oncology.

“We are curing more patients, more people, with the entire spectrum of treatments that we have available, including traditional cancer treatment, which is surgery, radiation and chemotherapy.

“But with the advent of immunotherapy and biologic therapies and other targeted agents, we have an expanding repertoire of very active treatments that really enhance our capability to cure or manage cancer for extended periods of time,” he said.

Increasingly, Billingsley said, cancer is being managed “like any other chronic disease, where what once was considered incurable now will be not only treatable but treatable for months to years, in many cases.”

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