Dealing With Cancer Recurrence

When Your Cancer Comes Back

(LifeWire) - For many people, the fear and distress caused by a cancer diagnosis are topped only by news that the cancer has returned. It's something many people start to worry about almost as soon as they hear they have become cancer-free.

Cancer Recurrence or Progression?

Hearing you have cancer again can be devastating. You may also wonder if this is a new cancer or a progression of the same type of cancer you fought before. There is no clear answer. According to the American Cancer Society, a cancer is considered to have recurred any time an individual classified as having become cancer-free has cancer cells return. If you have only been in remission for a few months when the disease is again discovered, your doctor will probably assume that it never completely left.

Types of Cancer Recurrence

Cancer recurrences are categorized according to where they appear:

• Local: Cancer cells are found where they were before, but they have not spread.
  
• Regional: Cancer cells are found in the previous site and in nearby lymph nodes, but not in other parts of the body.
  
• Distant: Cancer cells are found in a different part of the body. You may hear this type of recurrence referred to as a metastatic recurrence.

Worrying About Recurrence

Though it may be hard not to worry, experts say there are only a few symptoms that you need to look out for that could indicate a recurrence. If you or a loved one experiences any of the following symptoms after having had cancer, contact your physician immediately:

• Reappearance of the cancer symptoms that made you see a doctor in the first place
• Sudden, unexplained pain that continues for more than a week
• Unexplained and dramatic weight loss
• Fever not connected to flu or other common illness
• Unexplained swelling or lumps
• Unexplained coughing that continues for more than a week
• Persistent nausea or vomiting that continues for more than a week

Diagnosing Recurrences

A recurrence is more likely to be diagnosed early if you follow your doctor's recommended schedule of follow-up care. The schedule will depend on the type and stage of your cancer. These follow-up visits are an important time for you to discuss any symptoms you might be having. If your physician is concerned about a recurrence, you will probably undergo diagnostic testing. These tests could include blood work, MRI scan, ultrasound scan, CT scan and, in some cases, a biopsy.

Treating Recurrences

When you are diagnosed with a cancer recurrence, your physician should advise you of your treatment options. The possibilities will vary widely depending on your diagnosis.

Treating a recurrence isn't quite as simple because, in some cases, you may not be able to use the same treatment methods you became familiar with the first time around. In some instances, using the same chemotherapy medications will not be an option because the cancer cells may have developed a resistance to them.

According to the American Cancer Society, if your cancer returns within two years after ending chemotherapy, "it is possible that the disease has grown despite the chemotherapy." Your doctor will likely suggest a different medication that may be more effective.

Another reason to try different medicines is that certain medicines have toxicity that is only apparent after a certain threshold of drug exposure is reached. For example, anthracyclines used for the treatment of breast cancer can rarely be given twice because of cardiac toxicity when too much drug is used.

Coping and Finding Support

A diagnosis of recurrent cancer can be more devastating than the first time the cancer was identified. A second diagnosis usually means a second cancer and not recurrence. You may experience all sorts of emotions, including anger, distress, guilt and even blame. The American Cancer Society acknowledges that it may be natural to blame your doctor. If you feel that your physician didn't provide the care you required, don't be afraid to discuss this. A frank discussion with your physician may ease your concerns.

And although distress, anxiety, mood swings and depression are understandable, you should seek help if you have symptoms of depression that persist for several weeks. Depression can make it more difficult to proceed with treatment.

It's important not to bottle up your emotions. Share your feelings with your friends and family. Don't be afraid to truly share your fears, even if that means talking about death. It may be helpful to find support through others who are undergoing cancer treatment and dealing with a recurrence. Most communities have formal support groups available. You can also seek out an online community, such as those provided by Cancer.about.com or the American Cancer Society.

However you choose to give voice to your feelings and concerns, doing so in some fashion is simply crucial.

Sources: