When Cancer Comes Back

By Jane Farrell

From the National Cancer Institute, information every cancer survivor should know:

When cancer comes back after treatment, doctors call it a recurrence or recurrent cancer. Finding out that cancer has come back can cause feelings of shock, anger, sadness, and fear. But you have something now that you didn’t have before—experience. You’ve lived through cancer already and you know what to expect. Also, remember that treatments may have improved since you were first diagnosed. New drugs or methods may help with your treatment or in managing side effects. In some cases, improved treatments have helped turn cancer into a chronic disease that people can manage for many years.

Recurrent cancer starts with cancer cells that the first treatment didn’t fully remove or destroy. This doesn’t mean that the treatment you received was wrong. It just means that a small number of cancer cells survived the treatment and were too small to show up in follow-up tests. Over time, these cells grew into tumors or cancer that your doctor can now detect.

Sometimes, a new type of cancer will occur in people who have a history of cancer. When this happens, the new cancer is known as a second primary cancer. Second primary cancer is different from recurrent cancer.

Types of Recurrent Cancer

Doctors describe recurrent cancer by where it develops and how far it has spread. The different types of recurrence are:

• Local recurrence means that the cancer is in the same place as the original cancer or very close to it.
• Regional recurrence means that the tumor has grown into lymph nodes or tissues near the original cancer.
• Distant recurrence means the cancer has spread to organs or tissues far from the original cancer. When cancer spreads to a distant place in the body, it is called metastasis or metastatic cancer. When cancer spreads, it is still the same type of cancer. For example, if you had colon cancer, it may come back in your liver. But the cancer is still called colon cancer.

To figure out the type of recurrence you have, you will undergo many of the same tests you had when your cancer was first diagnosed, such as lab tests and imaging procedures. These tests help determine where the cancer has returned in your body, if it has spread, and how far. Your doctor may refer to this new assessment of your cancer as “restaging.”

After these tests, the doctor may assign a new stage to the cancer. An “r” will be added to the beginning of the new stage to reflect the restaging. The original stage at diagnosis does not change.

See our information on Diagnosis to learn more about the tests that may be used to assess recurrent cancer.

The type of treatment that you have for recurrent cancer will depend on your type of cancer and how far it has spread. To learn about the treatments that may be used to treat your recurrent cancer, click here to find your type of cancer among the PDQ® cancer treatment summaries for adult and childhood cancers.

Reprinted courtesy of the National Cancer Institute. Click here for more information