When Cancer Comes Back: Cancer Recurrence

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When cancer recurs

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 might be even stronger this time. You might feel more cautious, guarded, and less hopeful than ever before. You may be disappointed in your body and your healthcare team. Many issues and questions come with cancer recurrence. Here are some of the more common ones.

Is it a recurrence or a new cancer?

“I had breast cancer. Now they say I have cancer in my liver. How is that related to breast cancer? Is this a recurrence?”

It’s possible to have 2 different types of cancer, but it’s more likely that the first cancer has come back and spread to a new part of your body. When cancer spreads to a new location in the body, it’s said to have metastasized. The cancer growths that are now in the new locations are called metastases. But even when cancer has spread to a new area, it’s still named after the part of the body where it started. For example, if prostate cancer spreads to the bones, it’s still called prostate cancer, and if breast cancer spreads to the liver it’s still breast cancer.

When breast cancer cells spread to the liver, they still look like breast cancer cells even though they’re in the liver. Under the microscope, they won’t look like liver cancer cells. When a cancer started in the liver, it’s called liver cancer. But the liver is a common area of spread or metastasis in many types of cancer that start elsewhere. Then it’s not called liver cancer. A person with breast cancer that has spread to the liver is said to have breast cancer with metastases to the liver.

You will have tests to see if the cancer is the same type as you had before. Although it’s not possible to predict how likely a cancer is to recur, they are harder to treat and more likely to come back if they are:

  • Aggressive (fast-growing)
  • Found in later stages (more advanced cancer)
  • Widespread

Most types of cancer recur in a typical pattern – your doctor can tell you more about this if it’s 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’s no evidence of it at your check-up. 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. You would be said to have breast cancer (in remission) and liver cancer – 2 different kinds of cancer. Your treatment for the liver cancer would be different from the treatment you would get for recurrent breast cancer.

Last Medical Review: 07/28/2015
Last Revised: 07/28/2015