Ask any breast cancer survivor and they can likely tell you the date of their last day of treatment just as easily as they can tell you their birthday.

And most survivors especially mark the five-year anniversary of when they were diagnosed with cancer. That has traditionally been seen as a benchmark for when you could say, “My chances of having that cancer return is no longer likely.”

But oncology experts like Linda A. Jacobs, PhD, CRNP, a Nurse Practitioner and Director for the Development of Cancer Survivorship Programs, have long been wary of standing behind that benchmark.

The good news is that the risk of recurrence—the term for when a cancer returns—decreases each year for most cancers, explains Jacobs.

But there’s a caveat: “It’s different for every disease and different for every patient. People need to know that yes, it’s a great thing to reach that five-year mark, and most cancer survivors can be cautiously optimistic at that point. However, it doesn’t mean that the recommended follow-up and surveillance for anything should end,” she says.

Here's what you should do once you've reached the five-year survival mark.

Stay Vigilant

Jacobs says that once you’ve been diagnosed with cancer, it’s vital that you follow the surveillance schedule set up by your oncology team. Survivors must have the scans and lab work they’re instructed to get, and keep their appointments.

“That’s probably the most important thing people can do for themselves besides living a healthy lifestyle,” she says.

And while that may seem like a no-brainer, compliance can be a big issue.

“People tend to feel better. Consequently, some survivors don’t want to be constantly reminded of their disease,” Jacobs explains. “And they don’t want to be constantly going to appointments. However, it’s really important that they do so.”

Continue to Get All Screenings

Another important piece of surveillance that’s critical for you as a cancer survivor is having the recommended screening tests for other cancers, not just the one you were diagnosed with.

“In other words, if you’re a 45-year-old breast cancer survivor, five years from now—when you’re 50 years old and you survived breast cancer—you should be getting your colon cancer screening, which is recommended at age 50,” advises Jacobs.

As a cancer survivor, you may be at a slightly increased risk of developing a different type of cancer.

And even if you never get another cancer, you may experience long-term or late-occurring effects from the cancer treatment you received even five or more years after treatment has ended.

These late effects—which can occur as a result of the treatment received including radiation, chemotherapy, surgery or prescription drugs—can include problems with the thyroid gland, heart or lungs, as well as cognitive issues and emotional difficulties.

“For example, a breast cancer survivor whose left breast was radiated as part of her cancer treatment may be at increased risk for cardiac issues, since her heart was in the field of radiation,” explains Jacobs.

Target Late Effects

It’s estimated that about two-thirds of cancer survivors will experience one or more late effects of treatment.

As a leading research institute, we have a series of ongoing and recently completed studies that aim to better identify the most common issues for different cancers, including breast cancer—one, five or even 30 years down the road.

A key tool helping us figure that out is a groundbreaking electronic messaging system available to all patients called MyChart by myPennMedicine, the patient portal.

Currently part of a research protocol, a symptom questionnaire is sent to breast cancer survivors using this mechanism. The symptoms reported by the patient are then transmitted to the patient’s medical record to be addressed by the oncology team at the next follow-up visit.

Although the risks associated with having cancer or being treated for one may sound like bleak news, Jacobs stresses that surviving cancer has a much rosier picture than it used to.

“People often look to the past and think about people they knew who were diagnosed with cancer, such as their grandmother, uncle, aunt. And they have a negative image of what that actually means,” she says. “However, today it really doesn’t mean the same thing. We have very different treatments, better treatments today. We manage symptoms far better than we did in the past.