Recurrent Cancer: When Cancer Comes Back

You're in Control

Maybe in the back of your mind, you feared that your cancer might return. Now you might be thinking, “How can this be happening to me again? Haven’t I been through enough?” But you’ve lived through cancer once. You know a lot about what to expect and how to prepare. You know the health care team and people at the hospital. 

Remember that treatments may have improved since your first cancer. New drugs or methods may help with your treatment or in managing side effects. In some cases, improved treatments have helped turn cancer into a chronic disease that people can manage and live with for many years.

Cancer that returns can affect all parts of your life. You may feel weak and no longer in control. But you don’t have to feel that way. You can take part in your care and in making decisions. You can also talk with your health care team and loved ones as you decide about your care. This may help you feel a sense of control and well-being.

Why Cancer Comes Back

Recurrent cancer starts with cancer cells that the first treatment didn’t fully remove or destroy. This doesn’t mean that the treatment you received was wrong. It just means that a small number of cancer cells survived the treatment and were too small to show up in follow-up tests. Over time, these cells grew into tumors or cancer that your doctor can now detect.

Sometimes, a new type of cancer will occur in people who have a history of cancer. When this happens, the new cancer is known as a second primary cancer. Second primary cancer is different from recurrent cancer.

Types of Recurrent Cancer

Doctors describe recurrent cancer by where it develops and how far it has spread. The different types of recurrence are:

• Local recurrence means that the cancer is in the same place as the original cancer or very close to it.
• Regional recurrence means that the tumor has grown into lymph nodes or tissues near the original cancer.
• Distant recurrence means the cancer has spread to organs or tissues far from the original cancer. When cancer spreads to a distant place in the body, it is called metastasis or metastatic cancer. When cancer spreads, it is still the same type of cancer. For example, if you had colon cancer, it may come back in your liver. But, the cancer is still called colon cancer.

Staging Recurrent Cancer

To figure out the type of recurrence you have, you will have many of the same tests you had when your cancer was first diagnosed, such as lab tests and imaging procedures. These tests help determine where the cancer has returned in your body, if it has spread, and how far. Your doctor may refer to this new assessment of your cancer as “restaging.”

After these tests, the doctor may assign a new stage to the cancer. An “r” will be added to the beginning of the new stage to reflect the restaging. The original stage at diagnosis does not change.

See our information on Diagnosis to learn more about the tests that may be used to assess recurrent cancer.

Treatment for Recurrent Cancer

The steps you go through for treatment most likely will be the same as when you first had cancer, even if your treatment changes. Many people have a treatment team of health providers who work together to help them. This team may include doctors, nurses, social workers, dietitians, or other specialists. 

There are many treatment choices for recurrent cancer. You may have the same or a different treatment than you did for the first cancer. This will depend partly on the type of cancer and the treatment you had before. It will also depend on where the cancer has recurred, whether it has spread, and how your health is now.

Chemotherapy, surgery, radiation, biological therapies, or a combination of treatments may be options for you. Your doctor may also suggest a clinical trial that you may benefit from. It’s important to ask your doctor questions about all your treatment choices. You will want to know all the risks and benefits of treatment. And if you choose not to go through treatment again, palliative care can provide comfort care for you. 

To learn about the treatments that may be used to treat your recurrent cancer, find your type of cancer among the PDQ® cancer treatment summaries for adult and childhood cancers.