Dr. Keith Roach, syndicated columnist

DEAR DR. ROACH: I read your column every day. In a recent column. you wrote: “Since age is the major risk factor in getting cancer, it is likely that some people who were cured of their original cancer will later succumb to a different one.”

This statement terrified me as I fall into this category. I had a lobectomy in 2009 to remove a stage IA lung cancer that had not spread and for which I was not prescribed chemo or radiation. Annual CT scans since then have all been negative except for a pulmonary embolism in 2014, which resulted in a blood-thinner prescription. I’m told that I will need to be on the blood thinner for the rest of my life.

Two years ago, my oncologist said that I could opt out of the scans and yearly visits since my chance of a recurrence was “less than 1%.” (I think that was the percentage, or maybe I’m confusing it with something else she said.) Nevertheless, I decided to continue the scans and visits just to be on the safe side.

I rarely think about this cancer until it’s time for a scan and a visit. However, your column shed new light on the situation, and as I said, now I’m scared to death. My first question is: Was it really necessary for you to include this statement since it was bound to frighten a great many people like me, who may not routinely worry about a 15-year-old cancer but will now most certainly worry?

My second question is: What can you say about my particular situation that may assuage my fears? — J.G.

ANSWER: I am sorry to scare you. Every cancer survivor does know that a cancer can come back. However, this risk goes down over time. How much and how quickly the risk goes down depends on the type of cancer.

Your oncologist is right that for non-small cell lung cancer (I’m making an assumption), the risk is very low after 18 years. You should continue to follow her advice about follow-up scans.

What I was really referring to is that a person who’s had cancer is more likely to get a new and separate cancer than the average person (who has about a 25% to 30% chance of dying from cancer). So, a cancer survivor should be particularly diligent about following recommended cancer screening for other cancers, such as a mammogram, colonoscopy or PSA test (as appropriate for their age and sex).

Not all people (especially women) with lung cancer are current or former smokers, but those who are or were smokers should have careful exams of their mouths and throats. Lifestyle changes can also make a big difference in cancer risk, especially diet. A mostly plant-based diet reduces the risk of many cancers, and regular exercise helps as well. This is good advice for everyone — but especially those who have had cancer. Alcohol should be minimized or avoided entirely.

All of us live with the knowledge that we will die someday. Many people don’t like to think about it, but physicians need to so that we can give our patients the best advice on how we can best help them. For cancer survivors, this means being diligent about living wisely and getting the appropriate screening. It does not mean being obsessed with the possibility of an old cancer returning or a new cancer appearing.

EDITOR’S NOTE: Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.