No cancer survivor wants to hear the dreaded news that their disease has come back. However, many cancer recurrences are very treatable and potentially curable.
“We can treat recurrent cancer as a chronic disease and patients today are living longer and experiencing better quality of life,” said Endeavor Health oncologist and hematologist Amaryllis Gil, MD.
There are three types of cancer recurrence — local, regional and metastatic.
Both local (when the cancer comes back to the same spot) and regional (when it comes back in the lymph nodes near where it started) are typically treatable and may still be cured, Dr. Gil explained.
A metastatic recurrence means that the cancer has spread from its original location in the body to another site. Treatment often involves systemic therapies to control cancer growth, reduce symptoms and improve quality of life.
Recurrence timelines vary by cancer type
For many cancers, such as lung or pancreatic cancer, reaching five years cancer-free after treatment is often considered a victory, as the chance of recurrence diminishes significantly over time.
However, that five-year benchmark does not apply equally to all cancers. For cancers like breast cancer — and particularly hormone-receptor positive breast cancer — five years is no longer a seemingly magic point, explained Dr. Gil.
“With breast cancer, we do see patients recurring 10 plus years later,” she added. “But treatments are getting so much better and we tell our patients to have hope with new targeted medications available and more advanced therapies in development and on their way.”
Because recurrence can happen years later, long-term follow-up and paying attention to new symptoms, such as consistent pain, remain important. Listen to your body and talk to your physician if you notice any changes.
“Any pain that is new, persistent or worsening needs to be reported and checked out as soon as possible,” said Dr. Gil.
One of the most common places for breast cancer to metastasize is the bones, and then lungs or liver, explained Dr. Gil. When breast cancer spreads to bones, it typically does not occur below the knee or elbow.
Advances in targeted therapy and tumor testing
Even when cancer returns, treatment options today are more advanced than ever.
For patients with metastatic recurrence, getting new tissue samples to determine if it’s the same or different type of cancer as the original is critical. Next generation sequencing of tumor cells is vital to determine if there are targeted therapies for the specific mutations found in the cancer cells, said Dr. Gil.
Cancer that initially responded to one type of medication can develop resistance over time, and newer treatments may now be available that weren’t suitable during earlier-stage disease.
Advanced treatments — like immunotherapy and targeted therapies — are improving survival rates for almost every kind of cancer. The ongoing explosion of drug development means that even patients with recurring cancer are living far longer than they did 10 or 15 years ago.
Today, there are more than twice as many drugs available to treat breast cancer today than were on the market 20 years ago, and many of the new treatments have fewer and less severe side effects, said Dr. Gil. Better supportive medications are also in place that help patients better manage side effects and maintain daily living, she added.
Healthy habits, including regular exercise, avoiding smoking and alcohol, and maintaining a balanced diet can make a real difference in staying cancer-free and helping patients tolerate cancer treatments, said Dr. Gil.
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