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Health & Fitness

Will Cancer Come Back?

In tribute to Novato's Relay For Life, Novato Patch features excerpts from Juliane Cortino's forthcoming book, "Nothing Can Scare Me Now," to be released in late June.

     In the end, I did undergo chemotherapy. The treatments lasted three months and were exhausting. Most days, it took all of my energy to shower and make the bed. There were migraines. There was bone pain and hair loss. Food tasted bitter. By the time I had figured out how to manage, the radiation treatments began.

     I would just as soon have skipped the radiation. In my mind, I was cured of cancer. Surgery had removed the tumor. Chemotherapy should have wiped out any chance of metastasis. Yet, according to my radiation oncologist, there was still a twenty to forty percent chance that cancer could return to the same area without further treatment. As that is a large number, I signed up to be “zapped” by a linear accelerator every weekday for four weeks.

     Not long after my diagnosis, I’d met for a second opinion with Dr. Frank Stockdale, co-founder of Stanford University’s Combined Modalities Breast Cancer Program. Dr. Stockdale told me that the average woman with stage one breast cancer has a twenty-five percent chance of it recurring anywhere in the body. A woman with a high grade tumor, which mine was, has a one-in-three chance of having it return.

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     The time spent in Palo Alto, Calif. with Dr. Stockdale answered many questions, raised even more, and went by much too quickly. Much of what we discussed had to do with my particular case. But there were some items of broader interest. Dr. Stockdale noted that in Europe, surgery, radiation, and hormone treatment only would be given for a woman, such as me, with a stage one tumor less than two centimeters in size. I asked what sort of results Europeans are getting with this. “They’re willing to accept a fifty percent reduction in risk of recurrence,” he said, “where in the U.S. we’re getting a seventy percent reduction in risk. So they’re willing to accept that. There are lots of reasons. Some are economic and some are philosophic.”

     I asked why breast cancer comes. Dr. Stockdale said, “Most, eighty-five percent, are sporadic. There is no reason.”

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     Can a breast cancer patient ever really be cured, I wanted to know, or is there always a chance it will come back? His answer was, “There’s always a chance it will come back. But you markedly reduce those chances by taking treatment now. If you look at the national data on deaths from breast cancer, since about 1985, they’ve been going way down. The only real explanation for that is adjuvant (supplementary) treatment because the disease is the same disease.”

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