Living With Uncertainty: The Fear of Cancer Recurrence

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What is cancer recurrence?

Cancer recurrence is defined as the return of cancer after treatment and after a period of time during which the cancer cannot be detected. (The length of time is not clearly defined.) The same cancer may come back in the same place it first started or somewhere else in the body. For example, prostate cancer may return in the area of the prostate gland (even if the gland was removed), or it may come back in the bones. In either case it’s a prostate cancer recurrence.

The difference between recurrence and progression

When cancer spreads or gets worse it is called progression. Sometimes it’s hard to tell the difference between recurrence and progression. For example, if cancer has been gone for only 3 months before it comes back, was it ever really gone? Is this a recurrence or progression?

Chances are this is not really a recurrence. It’s likely 1 of 2 things happen in cases like this: One is that surgery left behind small clusters of cancer cells that could not be seen or found on scans or other tests. Over time they grow large enough to be detected or cause symptoms. These cancers tend to be very aggressive, or fast-growing.

The second possibility is that the cancer may be resistant to treatment. Chemotherapy or radiation may have killed most of the cancer cells, but some of them were either not affected or changed enough to survive the treatment. Any cancer cells left behind can then grow and show up again.

The less time between when the cancer was thought to be gone and the time it came back, the more serious the situation. Most doctors would agree that 3 months of appearing to be cancer-free before cancer returns is too short to be considered a recurrence. Although there’s no standard period of time in the definition of recurrence, most doctors consider it a cancer recurrence if you’ve had no signs of cancer for at least a year. If your cancer has been gone for only 3 months, this would most likely be a progression of your disease. In this case, the doctors would assume that the cancer never went away totally, even though they could not find it with any tests.

Last Medical Review: 06/19/2013
Last Revised: 06/19/2013