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The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on July 19, 2021.

What is cancer recurrence?

Even after removal and treatment, cancer sometimes returns. Doctors call this a cancer recurrence. It may resurface in the same area where it was first found or turn up at another spot in the body.

  • Local recurrence means it’s in the same spot.
  • Regional recurrence refers to the original cancer showing up in tissue or lymph nodes near the original site.
  • Distant recurrence means the cancer has been found in tissue away from the original location.

Your care team names the cancer based on where it originated. So if you had cancer in a breast and it recurred in your bones, it’s still considered breast cancer. When cancer spreads to one or more spots in your body, it’s said to have metastasized.

Cancer may return weeks to years after initial treatment. If cancer is found only a few months after it couldn’t be detected, it’s likely because surgery and treatment didn’t get all of it initially, and a tiny amount remained. This risk exists even though no remaining cancer could be found with scans or tests.

Sometimes cancer cells survive radiation and chemotherapy and become resistant to these treatments. In these cases, cancer may be considered not to have recurred but progressed, and it may be faster-growing or harder to kill. In general, the shorter the time between when cancer is first treated and when it reappears, the more severe the cancer risk.

Recurrence differs from developing a second form of cancer, which is a less common problem.

Risk of recurrence

How likely is the chance of your cancer recurring? It depends upon a few factors, including:

  • Type of cancer
  • Stage of advancement
  • Grade of original tumor
  • Previous treatment
  • Your age and health

Oncologists rate the development of cancer in stages. How staging is done varies, but the higher the number, the more the cancer has progressed. Once the condition of the primary tumor and any lymph node and metastatic involvement are analyzed, an overall staging number from 1 to 4 is assigned. These are also often divided into substages indicated by letters.

When staging was completed the first time you had cancer, and it’s repeated for a recurrence, it’s called restaging.

As an example of how staging affects recurrence rate, a large study of Swedish colon cancer patients, published in the Diseases of the Colon & Rectum journal, found that within five years after initial treatment, the recurrence rates were 5 percent for stage 1, 12 percent for stage 2, and 33 percent for stage 3.

Cancers with the highest recurrence rates include:

With breast cancer, most local recurrences happen within five years after treatment of an initial tumor, according to the Susan G. Komen organization. The risk for distant or metastasized recurrence remains the same whether you had a lumpectomy and radiation therapy or a mastectomy.

According to Susan G. Komen:

  • If you had a lumpectomy and radiation therapy, the risk of local recurrence within 10 years ranges from 3 percent to 15 percent.
  • If you had a mastectomy and no cancer cells were found in the underarm lymph nodes, the risk of local recurrence within five years is estimated to be about 6 percent. If you had a mastectomy but no radiation therapy as part of your treatment, and cancer was found in those nodes, the risk of recurrence in five years rises to 23 percent . However, the risk may be shrunk to about 6 percent with the addition of radiation therapy to your treatment.

Your tumor’s grade refers to the appearance of tumor cells under a microscope. Tumor cells that resemble normal tissue—called “well-differentiated”—are likely to grow more slowly than those that are abnormal in appearance, termed “undifferentiated” or “poorly differentiated.” The scale for grading runs from one to four, with the higher numbers associated with faster-growing tumors and a higher chance of recurrence.

Diagnosis and treatment

As a person who already had cancer, you’ve probably undergone follow-up examinations and various scans and blood tests. If signs are detected that the cancer may have returned, doctors may order more tests and a biopsy (tissue sample) to determine whether the suspicious site is cancerous and whether it’s a recurrence or something new.

If you become aware of physical symptoms you think may indicate cancer has returned, contact your doctor to get checked. Symptoms vary with the type of cancer and location, and they may be caused by reasons other than cancer. Some cancer symptoms include:

  • Lumps or swelling
  • Sores that don’t heal
  • Night sweats
  • Extreme fatigue
  • Unexplained loss or gain of 10 pounds or more
  • Persistent cough or hoarseness
  • Changes in bowel or urinary habits
  • Bloody stools or urine
  • Pain when urinating
  • Problems with swallowing
  • Abdominal pain
  • Nausea
  • Jaundice (yellowish cast to your skin or the white of your eyes)

How your medical team treats the recurrence depends on the type of cancer, whether the cancer is local or has spread, and factors such as whether it’s resistant to chemotherapy or other therapies.

For example, with prostate cancer, where the only sign of recurrence is an increase in a specific protein created in the prostate (called prostate-specific antigen or PSA), your doctor and you may decide to simply keep track of it and not do surgery or treatment unless further progression is seen. If prostate cancer has spread to other parts of the body, and surgery or radiation aren’t possible, then hormone therapy may be tried, but its success declines with time, and other treatments may then be employed.

Your doctor may use the terms “complete remission” or “partial remission/partial response” after you have undergone treatment.

  • Complete remission means tests show no detectable cancer in the body—it doesn’t mean you’re necessarily cured.
  • Partial remission/partial response means treatments have reduced, but not eliminated, the cancer.

If the cancer has returned and spread to distant sites, it’s called metastatic cancer. Common sites for distant tumors are the bones, liver and lungs, but cancer may spread to any tissue. Metastatic cancer symptoms depend on the size and location of tumors—and not all metastatic cancer results in symptoms.

Below are some common areas of the body and the associated symptoms.

  • Bones: broken bones and pain
  • Liver: jaundice or swollen abdomen
  • Lungs: difficulty breathing
  • Brain: dizziness, headaches or seizures

If you’re diagnosed with recurrent cancer that has spread to distant sites, treatment usually focuses on trying to control its growth. Efforts to maintain quality of life and reduce discomfort, called palliative care, may also be made. If your cancer progresses and can no longer be controlled, you and your doctor may discuss end-of-life care.

Your doctor may suggest a clinical trial. These trials look at the effectiveness and safety of new treatments that haven’t yet been approved by the U.S. Food and Drug Administration for general use. Participating in a trial may help fight your cancer and/or help other patients in the future.

What to ask your doctor

Recurrent cancer and its prognosis, testing and treatment are complicated topics. Speak with your oncologist about any concerns you have to gain a better understanding about your cancer, its stage and available treatments. Ask how certain treatments may reduce tumors or control the cancer’s spread—and don’t forget to inquire about their possible side effects. If you’re interested in entering a clinical trial, your doctor may point you toward any that are enrolling patients.

You may consider trying integrative therapies to alleviate cancer symptoms. Let your doctor know which of these you want to pursue so he or she can determine whether they may interfere with your medical treatments.

You should also tell your doctor about any vitamins and supplements you’re taking. Your oncologist may tell you to avoid certain products or treatments because they may not help or may be harmful.

When describing your prognosis, your doctor may use statistical terms, like those below, about estimating survival of cancer.

  • Disease-free or recurrence-free survival: The percentage of patients with no detectable cancer during a set time period
  • Cancer-specific or disease-specific survival: The percentage of patients with the same type and stage of cancer who survived their cancer during a specific time period
  • Relative survival: The percentage of patients with the same type and stage of cancer who have survived during a set time period after diagnosis compared with people without cancer
  • Overall survival: The percentage of patients with the same type and stage of cancer who have survived during a set time period after diagnosis

Finding support

Learning that your cancer has returned may be frightening and depressing, and it may fill you with uncertainty about the future. You’ve already gone through this trauma before—now it’s back. You may worry about what it means to you, your family, job and finances.

Sharing your feelings with other people in similar circumstances may help. By joining a support group, you may ask peers how they deal with issues related to cancer. Participating in a support group may improve your quality of life and reduce anxiety and the risk of depression. If you desire professional help, psychological counseling may assist you with difficult feelings and examine your experience with cancer.

Some patients find a sense of control over their diagnosis by making healthier choices about diet, exercise and mental self-care. You may also take strength from your past experience with cancer, the knowledge you gained from it, and the relationships you formed with your care team.

Since high-fat diets and obesity are associated with several forms of cancer, it’s thought that reducing the amount of fat you consume may help lower the risk of recurrence. Avoid or limit red meat, refined grains, sugars and alcohol. Eat plenty of vegetables of various colors, and be sure to include beans and peas, which contain fiber and protein.

Ask your doctor what level of exercise is appropriate for you. Activity improves your physical condition—not only your strength and endurance—and it may also lower symptoms of pain, fatigue, nausea and diarrhea. It may better your mental outlook, lessen anxiety and raise your self-esteem.

Help is out there. The U.S. Centers for Disease Control and Prevention and the National Cancer Institute have websites packed with information on cancer treatments (including integrative support), statistics, and advice for patients and caregivers.

The American Cancer Society and other nonprofit organizations provide information and services tailored to patients, families and caregivers. Some organizations are dedicated to a specific type of cancer, such as breast cancer, leukemia and lymphoma. Organizations may be local or regional, and some offer rides to treatment appointments, financial advice or assistance, free meals, or help with household chores. Your care team may be able to guide you toward what’s available in your area.

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