The joy and relief that comes with defeating cancer cannot be overstated. After the uncertainty and the emotional turbulence, a return back to a cancer-free life is often seen as a second shot at life. Hence it can be overwhelming to be told that the battle isn’t over, and you have to fight all over again. Do not despair though, you can win this.
What is it?
Cancer recurrence is the return of cancer after at least one year of remission. Some people may argue that the time frame can be as short as a few months. The shorter the timeframe between remission and recurrence, the more aggressive the cancer is. Whatever the time frame, cancer is said to recur when the same type of cancer happens again. Your medical team will confirm if it is the same kind of cancer and not a different one by examining the cancerous growth with the aid of a microscope.
If the cells are the same as those found in your first cancer, then it is a recurrence. This is irrespective of the location of the new growth. For instance, breast cancer can recur in the liver, provided the cells in the new tumour are the same as those found in the previous breast cancer, and not cells of the liver.
This must be distinguished from a second cancer diagnosis. In this case, the person has another cancer, after the first one. An example of this is getting a diagnosis of lung cancer which is primarily from lung tissue, after a previous diagnosis of testicular cancer which is in remission.
What are the types?
The recurrence of cancer can happen in different ways.
- Local recurrence
When cancer recurs in the same or close to the location of the initial episode. For instance, prostate cancer occurring in the prostate or close to it.
- Regional recurrence
Lymph nodes help to drain fluid from tissues in the body, and they function regionally. So, the recurrence is regional when it happens in lymph nodes or tissue close to the original site of the first tumour.
- Distant recurrence
As the name implies, cancer can also return far away from the location of the first one. This may be in one location or multiple locations. This is also called metastatic cancer because it occurs far away from the initial site.
What can cause this?
Cancer can return if the initial treatment did not get rid of all the cells. It can also occur if, during the process of surgery, some cells break off, or some are missed out. This is part of why doctors recommend chemotherapy or radiotherapy even after the surgery, to kill off any remnant of the tumour. Some cells may still be left behind. Remember that cancer cells are resilient and not so easy to kill. The left-behind cells may grow silently over a while, and during this time, you may be in remission because the mass is still too small to detect. Eventually, the mass becomes big enough to be noticed or picked up via medical tests.
What should you do when this happens?
A diagnosis of cancer recurrence can be devastating, and this is very understandable. If you get this diagnosis, it is important to let yourself go through the process properly. Allow yourself to feel the full range of emotions that come to you, from sadness to anger, denial, and even guilt.
After this phase, it is good to remind yourself of proven truths and discard thoughts without any objective basis. Remember that your mind is as important in this battle, as the drugs you are taking. So, eliminate all traces of guilt or self-blame. It is not your fault that cancer returned. Next, you need to recall that you have beaten cancer before, and you can beat it again. A general rule of thumb in life is that the first time is often the hardest.
Also, you have systems that helped you survive the onslaught of cancer the first time. These systems are tested and trusted. They may range from the support of your family, partner, and friends, to the support of your medical team. Just remind yourself that you weren’t alone the first time, and you wouldn’t be the second time.
You can also seek therapy if you are finding it difficult to come to terms with the diagnosis.
Lastly, don’t be afraid to discuss all your options with your doctor to determine the best course of action for you.
What are your options?
This may be a position you are familiar with, asking the doctor in a scared or bold voice what your options are. Your treatment options will largely be the same unless a newer method has been introduced since you went into remission.
Some of the factors that will guide your decision process include the location and spread of recurrent cancer. This can be the difference between active treatment and palliative care. Also, the time between your last treatment and the current diagnosis is important. Your body may not have recovered completely from the previous treatment and this may call for a gentler method to avoid tipping you over the edge. Other factors include the side effects of the previous treatment, how well the original therapy worked, and your general state of health.
The most important factor in all of these is what you want. Your aim for the management of recurrent cancer will play a huge role in whatever option you eventually choose.
Recurrent cancer may also make you qualified for experimental treatment or clinical trial of a new drug.
Whatever the case may be, never forget that you beat this once and you can beat it again. So, as you try to choose the best approach to defeating this cancer, remember that your mind is your secret weapon.
Feed it with positive thoughts, and don’t forget to smell the roses every chance you get. Live bravely, laugh unashamedly, and love without restraint.