When cancer comes back it can be devastating for you and the people closest to you. The medical work-up is difficult and all of the emotions you had when you were first diagnosed can resurface – and may be even stronger this time. You may feel more cautious, guarded, and less hopeful than ever before. You may be disappointed in your body and your health care team. Many issues and questions come with cancer recurrence. We have tried to address the more common ones here.
Is it a recurrence or a new cancer?
“I had breast cancer. Now they say I have liver cancer? How is that related to breast cancer? Is this a recurrence?”
It is possible to have 2 different types of cancer, but it is more likely that the first cancer has come back and spread to a new part of your body, like your liver. When cancer spreads to a new location in the body, it is said to have metastasized. The new cancer growths in the new locations are said to be metastases. But even when cancer has spread to a new area, it is still named after the part of the body where it started. For example, if prostate cancer spreads to the bones, it is still called prostate cancer, and if breast cancer spreads to the liver it is still breast cancer. A person with breast cancer that has spread to the liver is said to have breast cancer with liver metastases.
If in this case, breast cancer cells have spread to the liver, they will still look like breast cancer cells (even though they are in the liver). They will not look like cancer cells that started in the liver. The liver is a very common area of spread or metastasis in breast cancer, along with the lungs, lymph nodes, brain, and bones (usually the ribs and spine).
You will have tests to see if the cancer is the same type as you had before. Although it is not possible to predict how likely cancer is to recur, experience has shown that aggressive cancers (those that are fast growing), cancers that are more widespread, or those in later stages are harder to treat and more likely to come back. Most types of cancer recur in a typical pattern – your doctor can tell you more about this if it is something you would like to know.
If tests show a new area of cancer is a different type of cancer from the first type, you would be said to have 2 types of cancer. These 2 types of cancer will have started in different kinds of cells and look different under the microscope. This is much rarer than cancer recurrence, but it does happen.
Let’s say, for example, you were treated for breast cancer, and there is no evidence of it on your checkup. Then the doctor finds a tumor in your liver. This tumor turns out to be the type of cancer that starts in the liver cells, and not breast cancer that has spread to the liver. Then you would be said to have breast cancer (in remission) and liver cancer – 2 different kinds of cancer. You would be offered treatment for liver cancer, which is different from the treatment you would get for recurrent breast cancer.
Feedback
