What You Need to Know About Cancer Recurrence

If you are a cancer survivor, no matter how positive the prognosis, there is always the possibility that it may recur. That is just the nature of the disease, and furthermore, oncology is not an exact science, because there are many unknown factors that can influence recurrence. Knowing the odds helps some patients, but developing coping mechanisms may provide the most powerful tool to enable you to live life to the fullest after a cancer diagnosis.

The Likelihood of Recurrence

The likelihood that cancer will recur, possible timing of recurrence, and location of recurrence all depend on the type of primary cancer and staging. In general, the earlier the cancer is detected and treated, assuming it is localized, the better the survival rate. Some cancers have a predictable pattern of recurrence, and an oncologist can provide the likelihood of recurrence based on a patient’s medical history. However, it is impossible for physicians to know with certainty which patients will experience a recurrence.

Cancer can recur in local, regional, or distant locations from the original cancer. Local recurrence affects the same part of the body where the primary cancer was located. The cancer has not spread to the lymph nodes or other parts of the body. Regional recurrence affects the lymph nodes and tissue located in the vicinity of the original cancer. Distant recurrence means that the cancer has spread (metastasized) to areas far away from the original site, i.e., colon cancer that is in the liver.

When it comes to breast cancer, about 75 percent of breast cancers are estrogen receptor-positive (ER+), which means the cancer grows in response to the sex hormone estrogen. Breast Cancer Index (BCI) is a second-generation gene expression test that has been shown in clinical studies to predict risk of both early (0-5 years) and late (5-10 years) breast cancer recurrence, as well as the potential benefits of extended endocrine therapy. BCI is a unique predictive indicator of endocrine therapy benefit with growing evidence of utility across both the adjuvant and extended settings.

Recurrence by the Numbers: a Few Stats

Your oncologist may tell you that you have a 5-year survival rate, which refers to the percentage of patients who are alive at least five years after their cancer is diagnosed. It is important to keep in mind that these numbers are estimates – many people live much longer than five years after diagnosis. A 5-year relative survival rate compares survival among cancer patients to that of people of the same age, race, and sex who do not have cancer. Here are a handful of stats on cancer survival.

  • A large study found that about 15 percent of women lived with metastatic breast cancer at least five years after diagnosis.
  • As many as 30 percent of women with breast cancer will develop metastatic breast cancer, regardless of treatment or preventative measures.
  • About 90 percent of colon cancer patients have a 5-year survival rate when the cancer is localized.
  • In the earliest form of Stage I non-small cell lung cancer, there is a 5-year observed survival rate of 49 percent compared to just 1.0 percent in Stage IV.

Coping with Recurrence

Some patients experience the same kind of emotional response as they did with the original diagnosis. It is natural to feel shock, disbelief, anxiety, fear, anger, grief, and a sense of loss of control. After you beat the odds the first time around, it can be difficult to accept experiencing this all over again. But it is important to keep in mind that you now have insights and knowledge that you did not have before, and this can be very helpful. The power of knowledge is one viable way to cope with cancer when it recurs. Keep in mind that you have the following resources:

  • Knowledge about cancer, which can help reduce some fear and anxiety related to the unknown
  • Established relationships with doctors, nurses, and clinic/hospital staff
  • Knowledge of the medical system and terminology
  • A better understanding of navigating the system including health insurance
  • Awareness about cancer treatment, side effects, and strategies to reduce side effects
  • Familiarity with different sources of support, including family and friends, support groups, and professionals trained in providing emotional support
  • Experience with stress-reducing methods, such as yoga, meditation, or spending time with friends

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