Approved by the Cancer.Net Editorial Board, 10/2018
A recurrence occurs when the cancer comes back after treatment. This can happen weeks, months, or even years after the primary or original cancer was treated. It is impossible for your doctor to know for sure if the cancer will recur. The chance of recurrence depends on the type of primary cancer. Your doctor can give you more information about your risk of having a recurrence.
Why and how cancer recurs
Cancer recurs because small areas of cancer cells can remain in the body after treatment. Over time, these cells may multiply and grow large enough to cause symptoms or for tests to find them. When and where a cancer recurs depends on the type of cancer. Some cancers have an expected pattern of recurrence. A cancer may recur in the following ways:
- In the same part of the body as the primary cancer, called a local recurrence
- Near where the primary cancer was located, called a regional recurrence
- In another part of the body, called a distant recurrence
Recurrent cancer is named for the location where the primary cancer began, even if it recurs in another part of the body. For example, if breast cancer recurs distantly in the liver, it is still called breast cancer, not liver cancer. Doctors call it metastatic breast cancer. Metastatic means that the cancer has spread to another part of the body.
Diagnosing recurrent cancer
After treatment for primary cancer, you will receive a follow-up care plan. This plan includes a schedule for visits to the doctor, careful physical examinations, and possibly other tests. These visits and tests are important to make sure you are healthy and to watch for a recurrence. Depending on the type of cancer, you may need blood tests or imaging scans. But most of the time, a careful examination and conversation will be the only follow-up care. Your doctor may tell you to watch for specific signs or symptoms of recurrence.
If a recurrent cancer is suspected, you will likely need other diagnostic tests to learn more. These tests may include laboratory tests, imaging studies, or biopsies.
Making treatment choices for recurrent cancer
If testing confirms that you have a recurrent cancer, your health care team will talk with you about your treatment options. This process is similar to planning treatment for a primary cancer. Your doctor will consider the following factors:
- Your personal goals for treatment
- The type of cancer, where in the body it came back, and the size
- Your overall health
- The type of treatment you originally received and how well it worked
- Side effects you experienced with the original treatment
- How long it has been since finishing treatment
Your doctor may also suggest a clinical trial. When deciding among treatments, it is important to consider the following:
- The goals and expected benefits of each treatment
- The possible risks and side effects
- How each treatment could affect your quality of life
During treatment, relieving symptoms and side effects remains an important part of your care. This may also be called palliative care or supportive care. Talk with your health care team about your symptoms, including any new symptoms or a change in symptoms.
Coping with recurrent cancer
You may have many of the same feelings as when you were first diagnosed with cancer. Shock, disbelief, anxiety, fear, anger, grief, and a sense of loss of control are common emotions. All these feelings are normal responses to this difficult experience. Some people may even find this diagnosis more upsetting than the first one.
Many people with recurrent cancer also experience self-doubt about their original treatment decisions or choices after treatment. Remember that you and your health care team based those treatment choices on the information available at the time. Neither you or your health care team could predict the future.
Understandably, you may worry about having the strength to cope with another round of tests and treatments. But many people find that their previous experience better prepares them to face the challenges. For example, people with recurrent cancer have the following resources:
- Knowledge about cancer, which helps reduce some fear and anxiety related to the unknown
- Previous relationships with doctors, nurses, and clinic or hospital staff
- An understanding of the medical system, commonly used words, and health insurance
- Knowledge of cancer treatments and their side effects, as well as strategies to manage side effects
- Where to go for support, including family and friends, support groups, and professionals trained in providing emotional support
- Experience practicing stress-reducing methods, such as exercise, meditation, or spending time with friends
It is normal to experience emotional distress after a diagnosis of recurrent cancer. But seek professional help when the distress is long lasting and interferes with your ability to carry out daily activities. Counseling may help you in several ways, including:
- Learning ways to cope with difficult feelings
- Managing cancer symptoms and treatment side effects
- Exploring the meaning of your cancer experience
This may also be a good time to consider joining an in-person support group or online community to share your feelings and experiences with others in the same situation.
© 2018 American Society of Clinical Oncology. All rights reserved. Retrieved from https://www.cancer.net/survivorship/dealing-cancer-recurrence October 27, 2018. Reprinted with permission.