How are children surviving cancer today? Better than ever before. Some childhood cancer patients, now in their young adult years, are expecting to reach milestones in their lives others before them never would have reached.

Today, 1 in 1,000 young adults in the United States is a childhood cancer survivor. In the 1970s, the chance a child would outlive leukemia or lymphoma was 25 percent. Today, it's 80 percent. That's better than most adult recovery rates.

As recovery rates rise, a new frontier is on the horizon -- follow-up for these young people as they age. You see, the very treatments that saved these individuals may cause them complications later in life. It's not yet clear what happens when kids live 20 to 30 years beyond diagnosis. But teams at St. Jude Children's Research Hospital in Memphis, Tennessee, plan to find out as they launch one of the most ambitious follow-up programs to date. Contacting 5,000 patients who have survived for more than 10 years, doctors hope they will recruit a group to receive free check-ups for life. They'll also receive blood tests, MRI scans, even fertility counseling. Their medical histories will serve as rich textbooks for medical professionals and future patients -- so the war on childhood cancer can continue.

Join Living Beyond Breast Cancer (LBBC) for their next national teleconference, Follow-up Testing: What You Need to Know, from 12:00 p.m. to 1:30 p.m. Eastern Daylight Time (EDT) on Thursday, August 16. Virginia F. Borges, MD, of the University of Colorado Health Science Center, will answer your questions about follow-up testing after initial treatment, including:

• An overview of follow-up testing guidelines and insights into future tests
• Uses or limitations of screening tests
• Emotional impact of follow-up testing
• Routine follow-up tests for other health matters affected by treatment
• Creating a plan to monitor your overall health
• The role of follow-up tests for women with advanced (metastatic) breast cancer

Dr. Borges is an assistant professor of medicine at the University of Colorado Health Science Center. She specializes in the treatment of breast cancer, and her research interests include the study of new biologic therapies for breast cancer, development of cancer vaccines and improving the quality of life for people affected by breast cancer. In addition to her clinical practice and research efforts, Dr. Borges volunteers as a medical facilitator for Casting for Recovery.

After the presentation, Dr. Borges will answer questions

Living Beyond Breast Cancer will hold a free teleconference, Follow-up Testing: What You Need to Know, from 12:00 p.m. to 1:30 p.m. Eastern Daylight Time (EDT) on Thursday, August 16.

Speaker Virginia F. Borges, MD, will discuss follow-up testing after initial treatment, including follow-up testing guidelines, insights into future tests, the uses or limitations of screening tests and the emotional impact of follow-up testing. She also will explain the need for routine follow-up for other treatment-related health matters, creating a plan to monitor overall health and the role of follow-up tests for women with advanced (metastatic) breast cancer.

Dr. Borges is an assistant professor of medicine at the University of Colorado Health Science Center. Dr. Borges specializes in the treatment of breast cancer and her research interests include the study of new biologic therapies for breast cancer, development of cancer vaccines and improving the quality of life of people affected by breast cancer. In addition to her clinical practice and research efforts, Dr. Borges volunteers as a medical facilitator for Casting for Recovery.

This free program will feature a presentation by the speaker and a 45-minute question-and-answer session with participants. Participants can listen over the phone or use their computer.

To register, visit Living Beyond Breast Cancer's website at www.lbbc.org or call (610) 645-4567

Elizabeth Edwards, wife of Democratic presidential candidate John Edwards, has had many routine medical follow-ups since her 2004 breast cancer diagnosis. And all of them -- until just a few days ago -- resulted in what is generally termed a clean bill of health.

The term doesn't always come with a sense of relief for those of us surviving breast cancer -- or any cancer for that matter -- because it only really defines what our bodies are telling us at one specific moment. There are no magic blood tests, no special body scans, no conclusive ways of determining whether or not cancerous cells have gone astray and will one day surface again.

I asked my oncologist after my first six-month follow-up how he would know if my cancer returns. He told me it's really up to me to determine whether it comes back. It's up to me to get mammograms and ultrasounds and MRIs. It's up to me to report any symptoms and suspicions. It's up to me to track my general well-being so that it will be clear when something feels not-so-right. If I have a persistent cough or headaches that won't subside, my doctor will take action with X-rays and scans and tests. But as long as I feel fine and nothing troubling presents itself, then I remain in the clean-bill-of-health club.

Edwards no longer has a clean bill of health. But she is determined to use her newest diagnosis -- stage four metastatic cancer of the bones, considered treatable but not curable -- to work toward the best health she can acquire for as long as she can hold onto it. And that is about as good as any of us can do.

Cancer cells sometimes secrete specialized proteins into the bloodstream that serve as indicators of tumor growth. These tumor markers are often distinctly associated with a particular type of cancer. Like prostate cancer.

The most well-known tumor marker today is the PSA -- the prostate-specific antigen. PSA is a highly specific protein that is secreted only by cells of the prostate gland. It is one of the most widely used -- and the only widely accepted -- screening test for cancer.

There's also the tumor marker CA-125, used in the diagnosis of ovarian cancer and in the monitoring of response to treatment for the same disease. There's CEA for colon cancer, CA-19-9 for pancreatic cancer, AFP for liver and testicular cancer, beta-HCG for testicular cancer, and CA 15-3 for breast cancer. And research is under way on newer, more useful tumor markers. This is a good thing -- because some tumor markers are not specific enough or sensitive enough to accurately predict tumor growth.

This is why my oncologist does not recommend I enter the world of tumor markers, despite my status as a breast cancer survivor. He suggests I rely simply on how I feel for monitoring my chances for cancer recurrence. If I experience any worrisome symptoms, he will be the first to wage an all-out assessment of my health. But without symptoms, tumor markers are not likely to help me at all.

A peek at my breast cancer tumor markers would likely be hazy, inconclusive, and not all that helpful. Examination of tumor markers can lead to false positives. It can lead to expensive and often unnecessary follow-up testing. It can lead to worry and panic and even alarm if the numbers are not in the hoped-for range.

Although an abnormal tumor marker level may suggest cancer, this alone is typically not enough to diagnose the disease. Measurements of tumor markers are usually combined with other tests, such as a biopsy, to confirm cancer. So what would I do with an abnormal number and nothing suspicious to biopsy? I would worry. I would panic. Perhaps unnecessarily.

My doctor suggests I refrain from a wild cancer chase. And I am happy with his suggestion. Between my own awareness, follow-up oncology appointments, mammograms, annual OB/GYN check-ups, and more, I am confident any health issues that come my way will be detected early -- and can be resolved in good time. I have no need for confusing tumor marker details. Unless they are conclusively recommended, I will survive without them. More important, I will survive without worry.

I was examined yesterday by my radiation oncologist and two medical students during a six-month follow-up appointment. And any apprehension I had prior to the visit -- about a recurrence of breast cancer or the detection of cancer somewhere else in my body -- is gone. Because I walked away with the news that I am doing just fine. No lumps or bumps or suspicious masses were found. No enlarged lymph nodes were detected. And since I did not report any pain or tenderness or sensitivity or other trouble, I was sent on my way with nothing more than a notice for a return appointment in another six months. I have other appointments hanging in the balance -- one with my medical oncologist in August and a mammogram in November -- and I am sure hesitation and worry will again sneak into my head. But for now, I can only feel the true exhilaration that comes from truly good news. Like the exhilaration that comes from a breathtaking moment at the ocean -- where the power and beauty of the sea and the sky and the sand is all it takes for one five-year-old boy to feel amazingly free.

I am always a bit nervous before I head out for a check-up with my oncologists. I have two of them -- a medical oncologist who delivered my chemotherapy and a radiation oncologist who delivered my radiation therapy. Today I see my radiation oncologist and she will examine my breasts and manipulate my breasts and feel my underarms and check for lymphedema -- swelling in the arm due to removed lymph nodes -- and she will ultimately determine whether or not I have anything to worry about at this time. It's been just over one year since my last radiation treatment and six months since I saw this doctor for a follow-up.

So I am a little apprehensive about what I might hear -- because it's always possible that something does not feel right, that something is questionable, that something has returned. I am mostly confident that I am okay but there is still an unknown that lies ahead of me. An unknown that in a matter of a few hours will be known. And I will either learn that I am in fact okay. Or I will begin another spiral into the what-if-it's-cancer scenario. Only time will tell.

As they reach adulthood, the majority of childhood cancer survivors are unaware of the details of their treatment and the potential long-term health risks. As a result, many childhood cancer survivors do not seek the recommended aftercare from cancer specialists to monitor their health.

The researchers did report that childhood cancer survivors do see the family physician on a regular basis, but the experts feel these survivors should be seeing a specialist for the best in aftercare. I am not a childhood cancer survivor -- but I am a cancer survivor -- and I will tell you after active treatment for cancer I switched back to seeing my family physician as soon as I could for my aftercare. For me, it was psychologically beneficial. As long as I was seeing the oncologist, who happened to have her office in the same place where I received my chemotherapy, I was constantly reminded of the worst phase of my cancer. I felt stuck in time. I know if I develop any symptoms of cancer recurrence, my family physician will send me back to see a cancer specialist. In the meantime, when I go to see the doctor now, I feel like a normal person with a normal future. I am speculating, but this might be one of the reasons childhood cancer survivors seek their medical care from a family physician over an oncologist. I am not sure I feel the same concern as the experts do when it comes to where childhood cancer survivors go to receive aftercare -- as long as they are seeing a physician on a regular basis.