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Just when you started to move on with your life, you find out that the cancer you thought was gone has come back. You may have been worrying about recurrence since you completed treatment. This news probably leaves you with a lot of new questions and concerns. One of the biggest challenges during this time is uncertainty about what’s ahead. It helps to first understand what cancer recurrence is and how it is treated.
When the same cancer resurfaces in the body after a period of time following treatment and remission (in which the cancer could not be detected), it is called a recurrence, or recurrent cancer. Although it is possible to develop a new cancer unrelated to the original cancer, recurrence is more common.
A recurrence is a regrowth of the original disease. It means a small number of cancer cells may have been left behind after treatment. The cancer cells may have been too small to be seen in follow-up, but over time these cells became active and grew into detectable tumors. Cancer cells can return to the same place where the cancer first originated, or they can migrate to other parts of the body.
The following are the different types of cancer recurrence, based on where the cancer returns in the body:
Distant recurrence is also called secondary, or metastatic, cancer. It means the original cancer spreads (metastasizes) from the primary site to other areas of the body, often by way of the lymphatic system or bloodstream. The liver, lungs, lymph nodes, and bones are common areas of spread or metastasis.
Even when cancer has spread to a new location, it is still named after the part of the body where it started. For example, a person with breast cancer that has spread to the bones is said to have breast cancer with bone metastases. Metastatic cancer is considered advanced if it has aggressively spread to many places in the body, is affecting vital organs, or cannot be removed.
The risk of cancer recurrence is different for each individual. The chance that cancer will come back depends on the type and stage of the original cancer, the treatment you had, how long it has been since your treatment, and other factors. Although cancer recurrence is generally unpredictable, aggressive cancers, late stage cancers, or difficult-to-treat cancers tend to return more often.
When cancer recurs, it doesn't mean that the treatment you received was wrong or that you did something to cause the recurrence. Cancer can return even if you've done everything just right—eating right, exercising, and seeing your doctor for follow-up visits. Thus, it is important not to blame yourself for cancer recurrence.
You may have heard that cancer is more difficult to treat the second time around. However, a cancer recurrence does not mean you are without options and hope. A lot of progress has been made in the field of cancer research and treatments have likely improved since you first had cancer. Advanced treatment methods and technologies, as well as clinical trials, can provide new options to help treat recurrent cancer and/or manage its symptoms.
Although local cancer can be easier to treat than regional or distant cancer, there are options for all three. Surgery and radiation therapy are common treatment options for cancer that comes back locally. If the cancer returns to a distant site, treatment may depend on whether the cancer can be removed by surgery. If it can’t be surgically removed, various forms of chemotherapy, radiation therapy, or biological therapy may be used.
Sometimes the goal of treatment is to relieve symptoms. Palliative treatment helps relieve cancer-related symptoms, such as pain, to help improve quality of life. These treatments are much like the treatments used to fight cancer.
There is no right or wrong decision about how to handle cancer recurrence. Your treatment options will depend on cancer type, your previous treatments, the length of time between the original diagnosis and recurrence, the location of the recurrence, the extent of spread, your age, overall health, and personal goals. It is important to weigh the potential pros of a new treatment against the possible cons, such as side effects, to decide what works best for you.
News of cancer recurrence can be very upsetting for you and your loved ones. With the return of cancer come the shock, fear and uncertainties that accompanied your first diagnosis. Yet, a second cancer diagnosis can be even more distressing.
You may wonder about your future and feel discouraged at the thought of having to undergo treatments again. You may still be recovering physically and emotionally from your previous battle with cancer. You could be disappointed in your health care team, or blame yourself for past treatment decisions or lifestyle choices. You may feel anxious, sad, guilty, desperate, or angry. These feelings are all a normal part of cancer recurrence.
When cancer comes back, new questions may surface, such as the following:
Everyone handles cancer recurrence differently. While it can be difficult to accept the news at first, know that you are not alone. Also, if you consider all the things you can do for yourself to help cope with the situation, you can regain some control and feel more empowered.
NOTE: WHEN CANCER RETURNS, IT IS NORMAL TO EXPERIENCE STRONG EMOTIONS. IT IS IMPORTANT TO KEEP YOUR HEALTH CARE TEAM INFORMED ABOUT HOW YOU ARE FEELING.
NOTE: THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH PROVIDER PRIOR TO MAKING DECISIONS ABOUT YOUR TREATMENT.
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