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Cancer Recurrence

Overview

A cancer that comes back is called a recurrence. After cancer treatments, some people are afraid that the cancer will return. Unfortunately, there are no guarantees this will or will not happen. Life is full of uncertainty. Nobody has any guarantees beyond the present moment.

We've been there and been through this , just like you . We've danced in between hope and fear. We understand that fear can be very debilitating. CISN's best advice is to live your life fully, responsibly, and to cultivate trust.

Some cancer survivors will experience a return of the disease return in one form or another. If you have been diagnosed with a cancer recurrence, the benefit of having already gone through cancer is that you've done it once, and likely acquired insights and skills that you can apply in handling the recurrence.
  • A recurrent cancer grows from cancer cells that the first treatment did not fully remove or destroy. Some may have been too small to be detectable in follow-up.

  • This does not mean your treatment for the original diagnosis was wrong, or that you did something wrong. It just means that a small number of cancer cells survived the treatment. These cells grew over time into tumors or cancer that is now detectable.

  • When cancer comes back, it does not always show up in the same part of the body. For example, colon cancer may recur in the liver, which is called colon cancer that has metastasized or spread to the liver.

  • It is possible to develop a completely new cancer which has nothing to do with your original cancer. However, this is rare. Recurrences are more common.

 
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Different Types of Recurrences

Doctors define recurrent cancers by where they develop.

  • Local recurrence:
  • This means that the cancer is in the same place as the original cancer or is very close to it.

  • Regional recurrence:
  • This is defined as tumor growth in lymph nodes or tissues near the place of the original cancer.

  • Distant recurrence:
    In these cases, the cancer has spread (metastasized) to organs or tissues far from the place of the original cancer.

Local cancer may be easier to treat than regional or distant cancer. However, these details vary in each individual person.

Taking Control: Your Care and Treatment

After going through cancer once, having it return often presents significant challenges.

 

Remember that how you react is up to you! You can take part in your care and in making decisions.

You can communicate with your health care team and loved ones as you decide about your care.

Being proactive about your care may help you feel an improved sense of control and well-being.
 
Treatment Choices

There are many treatment choices for recurrent cancer. Your treatment will depend partly on the type of cancer and the treatment you had before. It will also depend on where the cancer has recurred. It is important to ask your doctor questions about all your treatment choices.

  • A local recurrence may be best treated by surgery and/or radiation therapy. This means that the doctor removes the tumor or destroys it with radiation.
  • A distant recurrence may need chemotherapy, biological therapy, radiation therapy, or other therapies.
  • A clinical trial may be an option for you depending upon your diagnosis.
Second Opinions

CISN strongly recommends that you seek out multiple opinions about treatments for your diagnosis. If you get a second opinion, the doctor may agree with your first doctor’s treatment plan. Or the second doctor may suggest another approach.

Either way, you have more information and perhaps a greater sense of control. You can feel more confident about the decisions you make, knowing that you’ve looked at your options. Many health insurance companies will pay for additional opinions.

Questions about Treatment Choices for a Recurrence

Here is a list of questions about treatment choices for a recurrence that you can expand upon to customize to your individual situation.

  • What are my treatment choices?
  • Which do you suggest for me?
  • How is this treatment the same as or different from my last treatment?
  • How successful is the treatment you recommend? Why is it best for me?

  • Will I still be able to do things I enjoy with the treatment? Without the treatment?
 
  • How long will I be on this treatment?
  • Will I have side effects? If so, how long will they last?
  • How can I manage the side effects?
  • Will I have to stay in the hospital?
  • Is a clinical trial available to me?
  • Will I have to pay any costs in a clinical trial?
  • If the treatment doesn't work, then what will I do?
Cancer as a Chronic Illness

For some, cancer is not a one-time event. Cancer can recur one or more times. For people who are able to control their disease over many years, cancer is considered a chronic illness.

The cancer may never go away completely, and yet people in this situation can live well over long periods of time. Although recurrent disease may not be cured, in some cases, it can be controlled. There is a chance that the cancer will go back into remission. For some people, the natural history of some cancers is one of recurrence and remission.

Every situation is unique depending upon many factors, including the location, stage, necessary frequency of treatments, available support systems, financial resources, age, and lifestyle preferences.

Repeated recurrences, often with shorter time periods in between disease-free intervals and/or treatment rounds, can be especially challenging for patients and their loved ones. The question of whether or not to continue treating cancer that repeatedly comes back is an important and difficult one to consider.

Your choices are personal and based on your needs, wishes, and abilities. There is no right or wrong decision.
 
Support

If you do not have a nurturing support system, CISN recommends that you take steps to build one.

Identify your needs and ask people for help. You may wish to identify a close circle of loved ones to serve as the central support team.

The central team can then coordinate support through a larger network of people.

Support may also be available through medical centers, non-profit organizations , and religious or spiritual centers.
 
 
 
 
 
 
 
 
 
 
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