Cancer recurrence is a reality, and here’s how to tackle it

Cancer recurrence can happen more than once, and it is important for you to know how to deal with it. An expert tells you the basics you MUST know.

Written by: Dr Tejinder Kataria

Published On: 7 Feb 2022, 02:01 pm IST

After the successful completion of treatment, if cancer is detected again, it is known as cancer recurrence. A cancer diagnosis is classified as a recurrence when a person has been cancer-free for at least a year. Unfortunately, a recurrence cannot always be foreseen. It depends on the type of cancer one was originally diagnosed with and treated for, also known as primary cancer. There are certain types of cancers that are much more prone to recurrence than others, such as breast cancer, lung cancer, colorectal cancer, ovarian cancer, and kidney cancer.

Types of cancer recurrence

There are three types of cancer recurrences:

* Local recurrence: When cancer appears in the same organ as the primary cancer

* Regional recurrence: When cancer occurs in organs close to where the primary cancer was detected

* Distant recurrence: when it occurs in another part of the body

Cancer is classified as a recurrence if after surgery or radiation the patient has been disease-free for six months. If it is present even at 3 months, it is residual. That means the previous tumour has not gone away. However, between three to six months, it is a recurrence.

Time interval between treatment to three months is when we expect the tumour to shrink. If it does not go down, it is called a progression. If a patient is free of it for more than six months due to surgery or radiation, it is called recurrence.

Difference between cancer progression and recurrence

This depends entirely on the time frame within which the cancer is detected. When the cancer returns within a short period, that is less than a year and proves to be more aggressive and resistant to treatment, it is known as progression.

Cancer recurrence diagnosis

In most cases, cancer recurrence is detected early. Once the patient has successfully completed treatment for primary cancer, they are on a strict follow-up plan. Their plan entails scheduled and periodic screening, blood tests, administration of oral medication, and physical examination. Due to an intensive and thorough follow-up, any indication, sign, or symptom that cancer has recurred, helps detect it early and is confirmed through imaging studies, PET scans, and biopsies.

How is a cancer recurrence treated?

Recurrent cancers may or may not respond to primary treatment! Therefore, the treatment needs to be modified depending on the type of recurrence, the extent, and the location of the cancer. Surgery and radiation therapy can be used for localized recurrences whereas aggressive treatments such as chemotherapy, biological therapy, or immunotherapy can be used more effectively against cancer that has metastasized.

Local ablative therapies like stereotactic, body radiotherapy and stereotactic radiosurgery are highly effective treatments for distant recurrence if the number of metastasis is less than 5 (oligometastatic disease). Often, the treatment of primary cancer causes significant stress on the patient and this further increases with an incident of recurrence. While this may cause a sense of fatigue and anxiety, patients should utilize their experience of fighting primary cancer to their benefit. In many patients, cancer can recur up to two to three times.