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

Bonnie Annis is a breast cancer survivor, diagnosed in 2014 with stage 2b invasive ductal carcinoma with metastasis to the lymph nodes. Catch up on all of Bonnie's blogs here!

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.

For more news on cancer updates, research and education, don’t forget to subscribe to CURE®’s newsletters here.