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.

What is the Risk of Recurrence?

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.

Treatment for Recurrent Cancer

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.

Adjusting to the News

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:

• Why is this happening to me again?
• Haven't I been through enough?
• What is going to happen now?
• What are my treatment options?
• What if I feel that I can't take more treatment?
• How will my family cope with the news?
• What am I going to do about finances?
• Will the cancer go back into remission?

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.

Tips for Coping When Cancer Returns

• Acceptance. You may wonder if you did anything to make the cancer come back. Although this feeling is normal, you should not blame yourself. Try not to focus on what could have been. Instead, try to accept the situation and use your inner strength to move forward.
• Do what is right for you. When cancer returns, your treatment goals may change, or they may be the same as with your first diagnosis. Think about what is important to you now and make thoughtful decisions about your treatment. And, let your cancer team know your goals. Only you can decide what is best for you.
• Set goals. Develop a plan that helps you live your life as fully and best as possible. It can help to set both short-term and long-term goals. Set small goals for each day, such as taking a walk, making a phone call, having lunch with a friend, reading a chapter of a book, etc. With places to go and things to do, you will feel more productive and fulfilled and you'll get your mind off cancer.
• Use lessons learned from the past. You have already battled cancer before. You are more experienced and knowledgeable this time around. Use what you learned in the past to deal with your present situation. Remember that as difficult as it was, you got through it. The same coping skills you used during your initial treatment can give you the strength and confidence you need now.
• Manage your symptoms. The symptoms of cancer recurrence can impact your quality of life. It is essential that you work with your cancer team to manage your symptoms, such as pain, fatigue, difficulty sleeping, etc. Improving physical symptoms can also improve your mood and overall well being.
• Seek emotional support. Feeling angry and upset about a cancer recurrence is completely normal. It is important to find support so you can express these feelings. Aside from family and friends, it helps to share feelings and concerns with others who are dealing with cancer recurrence and have been where you are now. In addition to support groups, you may also decide to seek private counseling.
• Nurture your spiritual well being. Spirituality can be a source of strength for many people. Cancer recurrence can make you to think about your beliefs. You may find comfort by exploring more deeply what is meaningful to you. Prayer, meditation, spending time in nature, or writing in a journal are just a few of the ways you can nurture your spiritual well being.
• Share with your loved ones. Your loved ones may also need time to adjust to the news, come to terms with their own feelings, and adjust to changing family roles. Remind your family and friends that you are still the same person you always were. Let them know that they can support you just by listening and being at ease with you.
• Plan ahead. Even when you are healthy, it helps to be prepared and make provisions for your family if the worst happens. Although it’s difficult to talk about these issues, if you have not already done so, you may decide to update your affairs through an advance directive or living will. Planning ahead can also help you worry less about the future, take control of the situation, and protect those you love most.
• Be open with your cancer team. Speak openly about your needs and concerns with your cancer team. Take the time to discuss all the available options with your doctors and your family members. Even if you are happy with your current doctor, this might be a good time to get a second opinion to explore all your options. You need to be comfortable with your decisions.
• Do things you enjoy. Try to participate in activities that matter most to you. Creative outlets, such as drawing, painting, music, and poetry can help you express yourself and relieve stress. You can also keep a journal, read a book, watch a funny movie, go fishing, make a scrapbook, and spend time with family and friends.
• Stay hopeful. When cancer returns, it can change the way you look at life. It's important to stay hopeful. You may have hope for new treatment options, hope for relief from symptoms, or hope for good times with family and friends. Hope can motivate you and make you feel empowered.

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.

At Cancer Treatment Centers of America (CTCA), we are here for you throughout your entire cancer journey. Once your hospital treatment is complete, our After Care Program is designed to help you maintain your health and improve your quality of life. Led by a registered nurse, this individualized survivorship program offers comprehensive follow-up care.

During your follow-up visits at CTCA, you will receive a series of tests to scan for metastasis, regardless of whether or not you are experiencing symptoms. Our clinicians will monitor your status and check for recurrence. The program is ultimately set up to help you regain independence, identify and manage potential late or long-term side effects, manage medications, and maintain a healthy lifestyle after treatment.

If you do experience a recurrence of cancer, CTCA cancer experts take a patient-centered approach that is based on your personal preferences and goals. In order to provide advanced options for recurrent cancer, our clinicians think outside of the box. They continually research and employ the latest cancer treatments and technologies to provide powerful and thorough treatment options for you.

In addition to new and innovative therapies for recurrent cancer, we also understand the importance of quality of life. At CTCA, you can expect to receive patient-centered cancer care for the whole person, not just the disease. Our clinicians deliver advanced conventional treatments in combination with complementary medicine therapies. We strive to help reduce symptoms, such as fatigue, so you can continue to participate in activities that are meaningful to you. Thus, our cancer experts help you fight the disease and enjoy a good quality of life.

At CTCA, we understand your needs in dealing with cancer recurrence are unique. We provide options, experts, quality care, and hope to support you in whatever decisions are best for you.

I hope this information has helped you in some way. I will check in with you again next month. In the meantime, stay strong and hopeful.