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PITTSBURGH (KDKA) – For cancer survivors, one of the biggest concerns is will the cancer come back?

It’s a question doctors have never really been able to answer. But, a simple blood test is changing the game.

Meghan Koziel is a young breast cancer survivor.

“I was diagnosed at only 26 years old,” she said.

She has been treated and reconstructed and her scans show no more cancer. But, the thought lingers.

“Now that I’m cancer-free one year, my biggest worry is that my cancer is going to come back,” she said. “And, typically, when a recurrence happens, it comes back a lot worse.”

There are risk factors for recurrence: larger tumors, spread to lymph nodes, younger age, and inflammatory breast cancer to name a few.

And, cells from the tumor itself may offer some clues. Genetic tests can help doctors decide how aggressive to be with chemotherapy.

The mainstay of preventing recurrence happens at the time of initial diagnosis and treatment: chemo, radiation, and hormone blockers. Along with alcohol avoidance and weight loss, especially with hormone receptor positive cancer.

How do survivors know, down the line, when to worry or not?

New tests are being developed that look for tumor cells or tumor DNA in the blood.

Studies on women five years out from treatment with no symptoms of recurrence, such as back pain or weight loss showed those with circulating tumor cells have 18 times the risk of the cancer coming back in about two years.

“It’s an interesting initial finding of using the test for high-risk patients, potentially to determine who should have increased screening, and/or designing interventions to perhaps prevent that recurrence, that is predicted to be more likely to happen,” Allegheny Health Network Dr. Michael Cowher said. “Maybe if there was a negative test, patients may feel better about the success that we have achieved with our original therapies.”

These blood tests are still in research, though.

“I think we’re at least five or maybe even 10 years away from having where we can clinically implement this test,” Dr. Cowher said.

Because of Koziel’s concerns, her doctor brought up the new test. While it isn’t standard, she knew this test was for her.

“She basically explained to me that it’s a newer test, it’s not something that she prescribes for every one of her patients. And they were really concerned with insurance paying for it,” Koziel said. “But I pretty much said we will find the money, I need this test done, to give me, like, a peace of mind, that my cancer really is gone.”

She had the test and it was covered by insurance.

“I guess I wasn’t really prepared for how many vials, but they do take quite a bit of blood,” she said.

Two weeks later, she got the results and reassurance.

“My circulating tumor cell test came back with a zero score. So, I’m cancer free,” Koziel said.