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What if cancer comes back?

Carcinoma - recurrence; Squamous cell - recurrence; Adenocarcinoma - recurrence; Lymphoma - recurrence; Tumor - recurrence; Leukemia - recurrence; Cancer - recurrence

One of the most common fears for people who have had cancer is that it may return after initial treatment. When cancer comes back, it is called recurrence. Cancer can recur in the same spot or in a whole different area of your body. No one likes to think about having cancer again, but it is important to learn about recurrence so you can move on with your life despite the uncertainty.

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Why Cancer Comes Back

Cancer can come back if any cancer cells are left behind after treatment. This does not mean that your health care team did anything wrong. Sometimes, these cancer cells can't be found by tests. But over time, they grow until they are large enough to be detected. Sometimes, the cancer grows in the same area, but it can also spread to other parts of your body.

There are three types of recurrence:

• Local recurrence. This is when the cancer occurs in the same spot again.
• Regional recurrence. This means the cancer has grown in the tissues or lymph nodes around the original cancer area.
• Distant recurrence. This is when the cancer has spread to an area far away from the original location of the cancer. When this occurs, health care providers say the cancer has metastasized.

Understanding Your Risk

This risk of cancer recurring is different for each person. Your own risk depends on several factors:

• The type of cancer you had
• The stage of cancer you had (if and where it had spread when you were first treated)
• The grade of your cancer (how abnormal the tumor cells and tissue appear under a microscope)
• Genetic characteristics of your cancer
• Your treatment
• The length of time since your treatment. In general, your risk gets lower the more time has passed since you were treated

To learn more about your own risk, talk with your provider. They may be able to give you some idea of your personal recurrence and any signs to watch for.

What You Can Do

While there is nothing you can do to make sure your cancer will not return, there are some steps you can take to try to stay as upbeat and healthy as possible.

• Keep your provider visits. Your provider will want to see you regularly after your cancer treatment is done. During some of these visits, your provider will run tests to check for cancer. If your cancer does come back, regular visits can help ensure it is found early, when it is often easier to treat.
• Do not drop your health insurance. After you have had cancer, you will need follow-up care for many years. And if your cancer does come back, you will want to make sure you are covered.
• Eat healthy foods. There is no proof that eating healthy foods will prevent your cancer from coming back, but it may improve your overall health. And there is some evidence that a diet rich in fruits and vegetables and low in saturated fats may help reduce the risk for recurrence of some types of cancers.
• Limit alcohol use. Some cancers are linked to drinking alcohol. Women should have no more than 1 drink a day and men no more than 2 drinks a day. Your risk is higher the more you drink.
• Get regular exercise. Exercise can help improve your overall health, boost your mood, and help you stay at a healthy weight. Some studies show that being overweight may increase the risk for recurrence of breast cancer.
• Try not to let your fears get the best of you. Focus on being as healthy as possible. Get back to your daily routine. Having a schedule can help you feel more in control. Focus on the little things that make you happy, whether it is having dinner with a friend, playing with your grandchildren, or walking with your dog.

What if Your Cancer Does Come Back?

If you do get another cancer diagnosis, it is normal to feel anger, shock, fear, or denial. Facing cancer again is not easy. But you have been through it before, so you have experience in fighting cancer.

Here are some things you can do:

• Learn all you can about your diagnosis and treatment options. Taking charge of your health care can help you feel more in control.
• Manage your stress. Cancer can make you feel stressed and anxious. Take time to do things that you enjoy. And learn a relaxation technique.
• Talk about your feelings with friends and family members. Think about joining a cancer support group or seeing a counselor. Talking can help you deal with the stress of fighting cancer again.
• Set goals. Both small goals and longer-term goals can give you things to look forward to. This can be as simple as finishing a good book, seeing a play with friends, or going somewhere you have always wanted to visit.
• Try to remain hopeful. Treatments continue to improve. These days, many types of cancer are managed like a chronic illness.
• Consider a clinical trial. Doing so may give you access to newer treatments. It can also help others learn from your cancer. Talk with your provider to see if one might be right for you.

References

Friedman DL. Second malignant neoplasms. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 50.

National Cancer Institute website. Tumor grade. www.cancer.gov/about-cancer/diagnosis-staging/diagnosis/tumor-grade. Updated August 1, 2022. Accessed October 28, 2022.

National Cancer Institute website. When cancer returns. www.cancer.gov/publications/patient-education/when-cancer-returns.pdf. Updated February 2019. Accessed October 28, 2022.

Rock CL, Thomson CA, Sullivan KR, et al. American Cancer Society nutrition and physical activity guideline for cancer survivors. CA Cancer J Clin. 2022;72(3):230-262. PMID: 35294043 pubmed.ncbi.nlm.nih.gov/35294043/.

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Review Date: 8/15/2022  

Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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