When Does Cancer End?

This article is part of the “Healing in Two Voices” series developed within the e-QuoL project, which brings together survivor voices and professional reflections on life after childhood and adolescent cancer.  In this series, professional contributions do not aim to add explanations or conclusions. They create spaces for reflection — ethical, psychological, and clinical — opened by the testimonies themselves.

1

My name is Andrea Cañisà, and at age 31, while pregnant with my second daughter, I was diagnosed with stage II classical Hodgkin lymphoma, nodular sclerosis variant.

For six months, I received chemotherapy every fifteen days at the Hospital Clinic of Barcelona.

When I put it that way, it sounds simple.

A diagnosis.

A treatment.

A remission.

But life doesn’t follow a straight path.

I’ve been in remission for two years now, and I still ask myself:

When does cancer really end?

No one talks about this.

Because treatments have an end date. So do chemotherapy sessions. There even comes a day when they tell you there’s no evidence of disease.

But it’s scary to ring the bell.

Because nothing guarantees that the cancer will never come back.

After that, you keep on living. As if a serious illness hadn’t taken a part of you away. A part of your identity. As if the cancer hadn’t left you with enough wounds.

You keep going in for checkups every three months with your heart racing.

For weeks, you’ve been trying to get back the life that cancer took from you.

To go back to work.

To sleep again.

To be a mother again.

To be yourself again.

But on the day of the checkup, none of that matters anymore.

Because the only question is this:

What if it comes back?

You’re using every last ounce of strength you have to recover, to rebuild what the illness tore down, and suddenly you find yourself sitting in a waiting room, waiting for an answer you have no control over.

Discovering that the body remembers things the mind would rather forget.

Sometimes I still wake up at night and, instinctively, shield the right side of my body, right where I had the Port-a-Cath. For months, I couldn’t sleep on that side because of the pain. Today it’s gone, but the reflex remains.

Pain has memory.

And so does the body.

Cancer hurts, but I’m not just talking about physical pain. We don’t talk about that enough either.

Because those of us in remission are fighting another invisible battle.

Because remission doesn’t mean forgetting.

For a long time, I thought cancer had taken up six months of my life.

Now I know that’s not true.

I’ve spent these two years in remission learning that remission isn’t about going back to being the person you were before.

It’s about discovering who you are afterward.

Who am I now?

Because cancer doesn’t just affect the body. It also shakes up questions, priorities, relationships, and decisions that may have been waiting years to be addressed.

Perhaps part of the healing begins here.

When fear is no longer the only voice.

When the disease is no longer the focus of every conversation.

When you realize that cancer will be part of your story, but it will no longer write every page of it.

And then, without even realizing it, you stop just surviving and start learning to live.

Not because the fear goes away.

But because, finally, it stops speaking alone.

Because those of us in remission shouldn’t be alone either.

Andrea Cañisà, survivor from Barcelona

2

As I listen to you, one phrase in particular resonates with me: “Pain has memory. And so does the body.”

I believe that in those few words lies a truth we talk about less than we should. We tend to talk about the diagnosis, the treatments, or remission, but much less about what happens afterward, about how such an intense experience continues to linger in the body and in life long after the signs of the disease have disappeared.

I’m moved by the image of that gesture that still appears at night, when you instinctively shield the side where you had the Port-a-Cath. As if the body had learned something that the mind no longer needs to remember. Your words remind us that remission doesn’t always coincide with the end of the cancer experience.

Over the years, I have accompanied many people who, once their treatments were over, wondered why they still felt so vulnerable. From the outside, it seemed like the time had come to celebrate and return to normalcy. However, for many of them, a different, less visible phase was beginning, one in which they had to learn to trust their bodies again, live with uncertainty, and find a way to come to terms with everything they had been through.

Another of your reflections also resonates with me: “Remission isn’t about going back to being the person you were before. It’s about discovering who you are afterward.” Perhaps for a long time we’ve understood recovery as a return to the past, when, for many people, it’s more like a process of rebuilding.

Your words make me wonder to what extent the healthcare system is prepared to support people through this stage. We tend to focus our efforts, and rightly so, on diagnosis, treatment, and symptom management. But once those needs begin to be met, other questions arise that also deserve attention: those related to identity, the fear of relapse, trust in one’s own body, or the meaning that life takes on after a serious illness.

Because, as you rightly say, there comes a time when fear is no longer the only voice. Perhaps a significant part of the healing process begins precisely there. And perhaps our responsibility as professionals is to continue bring present during that stage as well, when it’s no longer just about surviving, but about learning to live again.

Bernat Carreras, clinical psychologist at Hospital Clinic of Barcelona