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May 16, 2020 02:50PM
Salamandra, the issue of "active" treatment came up for me when I was being interviewed for a clinical trial. Endocrine therapy was not considered active treatment for the purposes of participation in this trial. I've also seen it referenced in the same way for medical travel insurance - rates are not increased once you are X number of years past diagnosis / out of active treatment, with endocrine therapy not considered active treatment.
And I found this in a PDF from Premera:
ACTIVE VS. HISTORICAL CANCER DEFINITIONS
Cancer is considered active when: The patient is currently and actively being treated and managed for
cancer. Scenarios demonstrating active cancer treatment/status include:
o Current chemotherapy, radiation, or anti-neoplasm drug therapy
o Current pathology revealing cancer
o A newly diagnosed patient awaiting treatment
o Affirmation of current disease management
o Refusal of therapeutic treatment by patient or watchful waiting The cancerous organ has been removed or partially removed and the patient is still receiving ongoing treatment such as chemotherapy or radiation.
Cancer is considered historical when: The cancer was successfully treated and the patient isn't receiving treatment. The cancer was excised or eradicated and there's no evidence of recurrence and further treatment isn't needed. The patient had cancer and is coming back for surveillance of recurrence. The patient is currently on adjuvant therapy (like Lupron or Tamoxifen) for prophylactic purposes.
That definition makes sense to me. It puts the treatment in context of where the patient stands with the disease and the treatment's role relative to the disease. It doesn't say or imply that there aren't side effects or health impacts from endocrine therapy; we know there are many impacts and the additional testing done on those who take Tamoxifen (endometrial cancer screening, for example) and AIs (dexa scans, for example) is proof that the medical and insurance communities are well aware of these side effects.
Dx 9/15/2005 Right, 7cm+, DCIS-Mi, Stage IA, Gr 3, 0/3 nodes, ER+/PR- ** Dx 01/16/2019 Left, 8mm, IDC, Stage IA, Gr 2, 0/3 nodes, ER+/PR-, HER2- (FISH) ** Surgery 11/30/2005 MX Right, 03/06/2019 MX Left ** Hormonal Therapy 05/2019 Letrozole