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Recurrent Disease

Cancer recurrence happens when cancer returns after treatment and after a period when no cancer could be detected. The timeframe of recurrence can vary. Cancer may return where it previously occurred or in another part of the body. Recurrent cancers can be referred to as local recurrence, regional recurrence, or distant recurrence. Cancer recurrence at the original site is called local recurrence. Regional recurrence refers to tumors developing in lymph nodes or tissues near the site of the first cancer. Distant recurrence is when cancer spreads far from its original site.

Causes and Risk

Recurrence can happen if the first treatment did not completely destroy all cancer cells. This does not mean the cancer was treated insufficiently, but rather that some cancer cells survived the treatment and developed into detectable tumors over time.

Cancer survivors face an increased risk of developing a second type of cancer and cancer recurrence. The chance of recurrence depends on the type of primary cancer, so cancer survivors should discuss the risk associated with their cancer type with their doctor. It is important to remember that cancer risk can be reduced, but not completely eliminated. While healthy eating, avoiding tobacco use, regular exercise, and consistent follow-up doctor visits are important, cancer recurrence is still possible.

Cancer Progression and Cancer Recurrence

When a cancer spreads or worsens, it is called cancer progression. It may be difficult to determine the difference between cancer progression and cancer recurrence. Typically, if a patient appears to be cancer-free at the end of treatment and the disease reappears after having no signs for a year, we say it is a recurrence. If the tumor grows while on treatment or never completely disappears and grows again after treatment, it is called progressive disease.

Symptoms of Recurrence

When treatment ends, your physician may outline specific signs or symptoms of recurrence to watch for. A follow-up care plan, including regular visits and screenings, will monitor your health for any unexpected changes. Report any symptoms to your physician immediately. 

Treatment Option Considerations

  • Type of cancer
  • Location of recurrence
  • Patient’s general health
  • Timing of recurrence
  • Extent of the spread of the cancer
  • Patient’s values and wishes

Treatment

Patients suspecting cancer recurrence should communicate with their oncologist about any symptoms they experience. Similar to a primary cancer, treatments for a recurrent cancer can be used to control and eliminate cancer as well as manage pain and side effects. Cancer treatments may have improved since a patient’s first cancer diagnosis, and new treatments may help manage side effects. Participating in a clinical trial may also be an option. Treatment for recurring cancer can include surgery, radiation therapy, proton therapy, chemotherapy, or biological therapy.

Sources: American Cancer Society, American Society of Clinical Oncology, Centers for Disease Control and Prevention, and National Cancer Institute

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