Surviving to Prosper

Aditya B | Physician |

The term survivor brings to memory a recent conversation I had with Ms. Jones (not real name) who had completed adjuvant chemotherapy for her breast cancer. I remarked “Congratulations! You are now a cancer survivor”. She excitedly exclaimed “So I am cancer-free!!!?”…

It made me reflect: does being a cancer survivor mean being cancer-free? At 5 years? 10 years? Can someone once afflicted with breast cancer ever be cancer-free?

Webster defines survivor as to “remain alive or in existence”, and “to continue to function or prosper”. The last term is crucial I think. The ability to contribute meaningfully to the society. Like a resilient soldier who survived the war weapons (aka chemotherapy in oncology), has bounced back (recovered), and is now ready for the next phase in life and achieve his/her purpose of life. By the way, does one ever know his/her purpose of life? Well, for now, mine is to write this blog…

Ms. Jones’ comments also make me wonder: how do we accurately gauze presence or absence of cancer in an individual? We know the radiological imaging studies including scans, mammograms, are not perfect and cannot detect micrometastatic disease. As done at some centers, particularly Europe, bone marrow biopsies could be done to detect disseminated tumor cells in the marrow. Even if one is able to detect malignant cells it does not distinguish dormant cells from those that have aggressive potential, i.e observers from the bad players. Conceptually, detection of circulating tumor cells (CTC) or circulating DNA might be an advance but is akin to detection of a needle in a haystack, and that too in lots of stacks. Maybe someday, with the help of ongoing efforts at the MGH CTC center, we will have the perfect technology to detect each and every cancer cell, though even then the critics would argue it does not prove they have cancer forming potential. Maybe we develop a test for that as well.

So, till we figure these issues out, how should we respond to the comments generated by patients like Ms. Jones? I personally will stick to the definition of “to function or prosper” as it provides a sense of optimism and purpose. It also saves me from having to go into the cancer detection argument…

I would welcome your thoughts and comments.


  1. I asked at one of my appointments when asked if I’m cancer free or in remission what do I say? I was told what I could say was I was a Survivor. I must say I like your focus when it comes to that term. It’s hard to hear that you can’t know 100% cancer is gone. Coming to terms with and being OK living with uncertainty can be a challenge. To function and prosper is certainly what I hope I’m doing. When I was told to say I’m a survivor I felt like that is such a bs term that says nothing. You can’t give the reassurance we all want but I think your focus on the meaning of survivor is perfect.

    M | | 7:56am

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