When Cancer Comes Back

Articles On Cancer Remission & Recurrence

Sometimes, cancer can come back after you've had treatment. This is what doctors call a recurrence. It's different from a new cancer. And it can show up anywhere in your body.

Experts usually consider it a recurrence if your cancer returns after you've had no signs of the disease for at least a year. Cancers can recur several times, and in some cases, might not ever go away for good.

While it's normal to feel scared, surprised, or sad when you hear "You have cancer" again, many treatments are available to help recurrent cancers.

Why Cancer Comes Back

The simplest explanation is that the treatment you had before didn't destroy all the cancer cells in your body. Even very small cells that were left behind can grow into tumors over time.

That doesn't mean you got the wrong treatment. Cancer cells are tricky, and some can survive aggressive therapies. It only takes a few cells.

What Recurrence Means

Cancer recurrence means the cancer you originally had has come back. It can develop in the same place it started or in a new part of your body.

When the cancer returns or spreads to a different spot, it's still named after the area where it started. For example, breast cancer that comes back in your liver is called a breast cancer recurrence.

Doctors typically classify recurrent cancers by how much they spread and where they crop up:

• Local recurrence: The cancer comes back in the same place, or very close to, where it first started.
• Regional recurrence: The tumor develops in the lymph nodes or tissues that are near the original cancer.
• Distant recurrence: The recurrent cancer has spread, or what doctors call "metastasized," to faraway organs or tissues in your body.

Tests such as imaging scans, lab tests, and biopsies can help your doctor figure out if your cancer has recurred.

A recurrence isn't the same thing as a second cancer. That's a new cancer that develops in another type of cell. Special tests can show your doctor if your disease is recurrent or a new kind. Second cancers are much less common than cancer recurrences, but they do happen.

Your doctor might also use the word "progression" to describe your cancer. This is different than a recurrence, but it's easy to confuse the two terms. It usually comes down to how much time you've been cancer-free. Recurrence is cancer that goes away and comes back, while progression is cancer that worsens or spreads. Cancer that seems to return quickly may have become resistant to treatment, so it's actually a progression.

Which Cancers Recur?

Doctors can't predict if your specific cancer will recur. But they do know cancers are more likely to come back if they grow fast or are advanced. The treatment you originally had may also affect your chances of recurrence.

Some types of cancer are more likely to come back than others. For example, about:

• 7 out of 10 women with ovarian cancer will have a recurrence.
• Half of people with colorectal cancer who get surgery will have a recurrence in the first 3 years after it.

In the future, genetic tests might be able to forecast whether certain cancers, such as breast cancer, colon cancer, and melanoma, will come back.

Treatment

Cancers that recur don't always respond as well to treatment as they did the first time.

Your treatment plan will probably depend on the type of cancer you have, how advanced it is, and where it's located.

If the cancer only recurs in the original site, surgery or radiation might be good choices. But if your disease has spread to distant areas of your body, you may need more aggressive treatments, like chemotherapy, biological therapy, or radiation.

You can also check out clinical trials. These research studies might allow you to receive new treatments that aren't yet available to the public.

A second opinion from another doctor can give you more ideas and help you decide what to do.

Life With Recurrent Cancer

Many people worry that their cancer will return. A study from the American Cancer Society found that a year after being diagnosed, around 2/3 of people were concerned about their disease coming back.

Some cancers come back only once, while others reappear two or three times. But some recurrent cancers might never go away or be cured.

This sounds scary, but many people can live months or years with the right treatment. For them, the cancer becomes more like a chronic illness, such as diabetes or heart disease.

While it may be hard not to fret, try to stay positive and remember that your situation is unique. And as treatments improve, so does the outlook for recurrent cancer.

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