© 2005-2012 American Society of Clinical Oncology (ASCO). All rights reserved worldwide.
- A recurrence occurs when cancer comes back after treatment. It may come back in the same place as the original cancer or elsewhere in the body.
- Treatment planning for a recurrent cancer is similar to the process for a primary cancer, but the specific treatment is likely to be different. For example, surgery is often the original plan for new cancers but usually has a smaller role in recurrent cancer.
- Recurrent cancers can be treated and sometimes even cured. With treatment, many people live a long time in this situation.
- If you are diagnosed with recurrent cancer, you likely will experience a wide range of emotions, many of which are similar to those you experienced when you were first diagnosed with cancer.
About cancer recurrence
A recurrence occurs when the cancer comes back. Cancer recurs because small areas of cancer cells may remain undetected in the body after treatment. Over time, these cells may multiply and grow large enough for tests to identify them. Depending on the type of cancer, this can happen weeks, months, or even many years after the primary (original) cancer was treated.
However, it is impossible for doctors to know which patients will experience a recurrence. The likelihood that a cancer will recur and the likely timing and location of a recurrence depend on the type of the primary cancer. Some cancers have a predictable pattern of recurrence, and a doctor familiar with your medical history can give you more information about your risk profile.
The recurrence may be local (returned to the same part of the body where the primary cancer was located), regional (came back to an area near the primary cancer), or distant (returned to another part of the body). Cancer that recurs in site distant from the location of the primary cancer is still named for the part of the body where the primary cancer began. For example, if a person treated for breast cancer now has cancer in her liver, doctors will say that she has metastatic breast cancer (breast cancer that has spread to a distant organ), not liver cancer.
Diagnosis and treatment
After treatment for primary cancer ends, your doctor may give you a follow-up care plan to monitor your recovery and watch for a potential recurrence. Follow-up care usually includes visits to the doctor and a careful physical examination. For some cancers, there are blood tests or other imaging to check for a recurrence. Most of the time, however, the careful examination and conversation will be the only follow-up care. In addition, your doctor may tell you to watch for specific signs or symptoms of recurrence.
If recurrent cancer is detected, your doctor will order additional diagnostic tests—such as laboratory tests, imaging studies, or biopsies—to learn as much as possible about the recurrence. After testing is done, you and your doctor will talk about your treatment options. This is similar to the process of planning treatment for a primary cancer.
When recommending a treatment plan, your doctor will consider the type, location, and size of the recurrent cancer, as well as your overall health. Additional considerations include the type of treatment you originally received, how the cancer responded to treatment, the side effects from the original treatment, and the amount of time that has passed since treatment for the primary cancer ended. Your doctor may also suggest a clinical trial that is studying new ways to treat this type of recurrent cancer. When deciding among treatments, it is important to consider the goals and expected benefits of each treatment, as well as the possible risks, side effects, and effect on quality of life.
Meanwhile, relieving symptoms and side effects will remain an important part of your cancer care and treatment. This may also be called symptom management, palliative care, or supportive care. Be sure to talk with your health care team about symptoms you experience, including any new symptoms or a change in symptoms. Learn more about palliative care.
Emotions and coping
If you are diagnosed with recurrent cancer, you may experience many of the same feelings you did when you were first diagnosed with cancer. Shock, disbelief, anxiety, fear, anger, grief, and a sense of loss of control are common emotions. All these feelings are normal responses to this difficult experience. Some people may even find this diagnosis more upsetting than the first one.
Many people with recurrent cancer also experience self-doubt about their original treatment decisions or choices after treatment. It is important to remember that the choices you and your doctor made at the time of your original treatment were based on the information available to you and your doctor at the time. Neither you nor your doctor could predict the future.
Understandably, patients diagnosed with recurrent cancer may worry that they will not have the strength to cope with another round of tests and treatments. However, many patients find that, based on their previous experiences, they are better prepared to face the challenges. For example, patients with recurrent cancer have the following resources:
- Knowledge about cancer, which helps reduce some fear and anxiety related to the unknown
- Previous relationships with doctors, nurses, and clinic or hospital staff
- Knowledge of the medical system and terminology
- A better understanding of their health insurance
- Familiarity with cancer treatments and their side effects, as well as strategies to reduce side effects
- Familiarity with different sources of support, including family and friends, support groups, and professionals trained in providing emotional support
- Experience practicing stress-reducing methods, such as exercise, meditation, or spending time with friends
Although it's normal to experience emotional distress after a diagnosis of recurrent cancer, it's important to seek professional help when the distress is long lasting and interferes with your ability to carry out daily activities. Counseling may help you learn ways to cope with difficult feelings, manage cancer symptoms and treatment side effects, and explore the meaning of your cancer experience. This may also be a good time to consider joining a support group where you can share your feelings and experiences with others in the same situation.