What Is Cancer Recurrence?

A cancer diagnosis can be devastating. But when the disease returns after months or even years of living cancer-free, many patients feel disappointed, helpless, and angry. They may wonder “Why me?” or “What did I do wrong?”

Recurrent cancer, or cancer that comes back after remission, happens when cancer cells go undetected by blood tests and scans. These cells then divide and grow into cancerous lesions that, in many cases, are harder to treat than primary tumors. With this in mind, SERO’s radiation oncologists offer the most advanced radiotherapy techniques for treating recurrent cancers.

Remission is a milestone in your cancer journey. However, it does not mean that your cancer is cured. 

Rather, remission means “a decrease in or disappearance of signs and symptoms of cancer.” Remission represents a major step in cancer care and long-term health. Blood tests may indicate a reduction in cancer cells or scans like X-rays may show a reduction in the size of your tumor or complete disappearance. This reduction has to last for at least a month for your cancer to be considered in remission.

When patients reach this stage, symptoms like pain and weakness often lessen. A patient’s cancer care team may decide to continue chemotherapy or radiation to prevent existing cancer cells from growing, though the dosage is often less. Some patients stop treatment altogether. Whether or not your oncologist adjusts your treatment plan depends on what type of remission you are in. 

There are two types of remission:

Though patients often use the terms “remission” and “cured” interchangeably, the two are significantly different. 

Complete remission means no evidence of cancer can currently be detected. However, cancerous lesions that are too small to visualize using a CT scan or X-ray may still exist. A tumor as small as one-millimeter, for example, does not show up on scans but can still contain as many as 100,000 cancer cells1.

Because the probability that the cancer will return is still high, complete remission does not mean a patient is cured. 

Rather, the term “cured” is only used when the patient is in complete remission for five years or longer. Since certain cancers can return even after this five-year mark, some patients are never truly cured.

Even when a cancer patient enters remission, there is still a chance that the cancer will come back. This is called a cancer recurrence and happens when a small number of cancer cells survive treatment but are not detected during blood tests or imaging scans. Over time, these cells grow and multiply. 

Recurrent cancer is different from second cancer, which is a cancer unrelated to any previous diagnosis. 

There are three types of recurrent cancer:

It is easy to let the fear of cancer recurrence dominate your life. Many cancer survivors obsess over their health, worrying about random headaches or digestive issues. It is important to remember that we all experience unexplained aches and pains. However, if certain symptoms persist, notify your doctor immediately. 

Let your cancer care team know if you experience any of the following symptoms:

• Return of the cancer symptoms you experienced before (for example, a new growth where your cancer started)
• New or unusual pain
• Easy bleeding or bruising
• Unexplained weight loss
• Chills or fevers
• Frequent headaches 
• Nausea, vomiting, or loss of appetite
• A persistent cough 

After a physical exam, your doctor may order blood tests or an imaging test. If these diagnostic tools suggest cancer, your oncologist will order a biopsy to confirm the type and stage of your cancer and to determine an appropriate cancer treatment plan.  

How your care team treats your cancer depends on a number of factors, including:

• Type of cancer
• When and where it recurs
• If it has metastasized 
• Your health
• Your goals and values 

Sometimes, your oncologist may suggest the same treatment you received previously. For instance, a patient who previously had surgery to remove a cancerous polyp in their colon may have a second surgery. This procedure may be followed by radiotherapy, a localized treatment used to kill any remaining cancer cells.  

But if a patient previously received a more aggressive treatment such as chemotherapy, the oncologist may suggest a different approach. Cancer cells can become resistant to chemotherapy drugs. These drugs are also very hard on the body and can cause serious issues like heart and vascular problems. 

As your doctor explains different care options, remember that you ultimately choose your cancer treatment. Only you can decide if you want to move forward with treatment or if you would rather seek palliative care to improve your quality of life

What is the probability that your cancer will return? That depends on many different factors, including:

There is always a possibility that your cancer will return. No amount of clean eating or aerobic exercise can truly prevent cancer recurrence. However, there are some steps you can take to be as healthy as possible. 

More specifically, SERO’s radiation oncologists suggest that cancer survivors:

• Eat a plant-based diet that incorporates a variety of fruits, vegetables, and whole grains. Limit or avoid red meats (beef, pork, lamb) and avoid sugary beverages. 
• Achieve a healthy weight. Studies show that being overweight or obese puts you at risk for developing 13 types of cancer8. 
• Talk to your cancer care team about beneficial vitamins and supplements. Certain supplements may actually increase the risk of cancer, so consult your doctor first. 
• Get at least two hours and 30 minutes of moderate-intensity aerobic activity each week. This could be hiking, biking, and even raking leaves. The key is to find an activity that you enjoy doing.

It can be hard to accept that, despite positive lifestyle changes, your cancer has returned. But these changes are still worthwhile. By adopting a healthy diet and regular exercise routine, you can prevent comorbidities like diabetes and heart disease that make successful cancer treatment more difficult. Download our free Guide to Diet & Nutrition During Radiation Therapy for additional insights.

At SERO, our radiation oncologists improve patient outcomes by providing the most effective and advanced radiotherapy techniques for treating recurrent cancer. To learn more about your cancer treatment options, contact us to schedule an appointment at one of our cancer treatment centers. We offer convenient oncological services across the Charlotte area.  

1. https://theconversation.com/my-cancer-is-in-remission-does-this-mean-im-cured-95429
2. https://www.cancertherapyadvisor.com/home/tools/fact-sheets/cancer-recurrence-statistics/
3. https://www.tandfonline.com/doi/full/10.1080/14737140.2017.1398088
4. https://pubmed.ncbi.nlm.nih.gov/30086050/
5. https://www.esmo.org/oncology-news/Patients-aged-75-79-years-at-higher-risk-of-distant-recurrence-than-patients-aged-70-74-years-in-the-older-population-70-years-of-patients-with-early-stage-breast-cancer-despite-higher-competing-mortality
6. https://www.endocrineweb.com/news/thyroid-diseases/62791-thyroid-cancer-how-age-affects-risk-recurrence
7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5181206/
8. https://www.cdc.gov/cancer/obesity/index.htm