Dealing With Cancer Recurrence

Approved by the Cancer.Net Editorial Board, 02/2016

A recurrence occurs when the cancer comes back after treatment. This can happen weeks, months, or even many years after the primary or original cancer was treated. It is impossible for your doctor to know for sure if the cancer will recur. The chance of recurrence depends on the type of the primary cancer. Your doctor can give you more information about your risk of having a recurrence.

Why and how cancer recurs

Cancer recurs because small areas of cancer cells can remain in the body after treatment. Over time, these cells may multiply and grow large enough to cause symptoms or for tests to identify them. When and where a cancer recurs depends on the type of cancer. Some cancers have an expected pattern of recurrence. A cancer may recur in the following patterns:

  • In the same part of the body as the primary cancer, called a local recurrence

  • Near where the primary cancer was located, called a regional recurrence

  • In another part of the body, called a distant recurrence

Recurrent cancer is named for the location where the primary cancer began, even if it recurs in another part of the body. For example, if breast cancer recurs distantly in the liver, it is still called breast cancer, not liver cancer. Doctors call it metastatic breast cancer. Metastatic means that the cancer has spread to another part of the body.

Diagnosing recurrent cancer

After treatment for primary cancer, you will receive a follow-up care plan. This plan includes a schedule for visits to the doctor, careful physical examinations, and possibly other tests. These visits and tests are important to make sure you are healthy and to watch for a recurrence. Depending on the type of cancer, you may need blood tests or imaging scans. Most of the time, however, a careful examination and conversation will be the only follow-up care. Your doctor may tell you to watch for specific signs or symptoms of recurrence.

If a recurrent cancer is suspected, you will likely need additional diagnostic tests to learn more. These tests may include laboratory tests, imaging studies, or biopsies.

Making treatment choices for recurrent cancer

If testing confirms that you have a recurrent cancer, your doctor will talk with you about your treatment options. This process is similar to planning treatment for a primary cancer. Your doctor will consider the following factors:

  • The type of cancer, where in the body it came back, and the size

  • Your overall health

  • The type of treatment you originally received and how well it worked

  • Side effects you experienced with the original treatment

  • How long it has been since finishing treatment

In addition to treatments similar to those used for the primary cancer, your doctor may also suggest a clinical trial. When deciding among treatments, it is important to consider the following:

  • The goals and expected benefits of each treatment

  • The possible risks and side effects

  • How each treatment could affect your quality of life

It is also important to talk with your doctor about your personal goals for treatment. This will help your doctor find the best treatment options for you.

During treatment, relieving symptoms and side effects remains an important part of your care. This may also be called symptom management, palliative care, or supportive care. Talk with your health care team about symptoms you experience, including any new symptoms or a change in symptoms. Learn more about palliative care.   

Coping with recurrent cancer

You may experience many of the same feelings you did when 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. Remember that you and your doctor based those treatment choices on the information available at the time. Neither you nor your doctor could predict the future.

Understandably, you may worry about having the strength to cope with another round of tests and treatments. However, many patients find that their previous experience better prepares them 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

  • An understanding of the medical system, commonly used terms, and health insurance

  • Knowledge of cancer treatments and their side effects, as well as strategies to reduce side effects

  • Where to go for 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

It's normal to experience emotional distress after a diagnosis of recurrent cancer. However, seek professional help when the distress is long lasting and interferes with your ability to carry out daily activities. Counseling may help you in several ways, including:

  • Learning ways to cope with difficult feelings

  • Managing cancer symptoms and treatment side effects

  • Exploring the meaning of your cancer experience

This may also be a good time to consider joining a support group to share your feelings and experiences with others in the same situation.

More Information

Managing Emotions

Making Decisions About Cancer Treatment

Coping with Metastatic Cancer

What is a Second Cancer?