“You have won the battle against cancer.” These words from your doctor will give you a feeling of relaxation and happiness. But, somewhere deep inside, you have a fear of your cancer relapsing. And, when that fear turns into reality, it can be distressing and shocking for you and your family.
Every emotion that you had when you were first diagnosed, rushes back to you, and this time they are stronger. You may feel more insecure and hopeless. This news of cancer recurrence comes with several questions: Why me? What went wrong? What is the future now? and many more …
When cancer comes back after a period of remission (which means the cancer is under control after treatment), it’s considered a recurrence.
Cancer recurrence can happen in the same site when it is called ‘local recurrence’ or if has spread to different parts in the body when it is called ‘distant recurrence.
Recurrent cancer can occur due to several reasons, mainly when cancer cells are not completely removed or destroyed by the first treatment or the cells that were resistant to treatment start growing again or when cancer cells that went dormant get reactivated after some time which could extend up to several years. These are the microscopic cells that survive the given treatment and were too small to be diagnosed in the follow-up.
Types of recurrent cancer
As mentioned above, recurrent cancer can occur at the previous place or in any other part of the body. Based on the location and its extent, it is of categorized into three types:
- Local recurrence is present in the same location where primary cancer occurred or very close to it.
- Regional recurrence is cancer that has grown in the tissues or lymph nodes present near the original location of cancer.
- Distant recurrence is cancer that has spread to tissues or organs located far from the original cancer location. These types of cancers are known as metastatic cancer.
Diagnosis of recurrent cancer
It is diagnosed in the same way as other cancers. Your doctor might suspect cancer, based on the signs and symptoms or some follow-up tests. It is difficult to diagnose recurrent cancer compared to the initially diagnosed cancer.
Treatment of recurrent cancer
Mostly, the local and regional recurrent cancers are curable. In this case doctors can perform a surgery to remove recurrent cancer. Sometimes additional radiation or chemotherapy may be required. Length of period of remission largely determines the outcomes and the treatment options doctors have.
Certain factors like type, location, and spread of cancer will be considered while planning the line of treatment. Your overall health will also be considered while planning the treatment. The type of previous treatment and body response to the treatment will also be noted. The doctor will discuss all the treatment options with you, explaining the goal and effectiveness of the treatment.
You can also join a clinical trial to get the latest treatments or experimental drugs. However, before going for this, completely understand the goal and outcome of the trial.
Whatever you decide, you should be mentally and financially prepared for your decision. It is better to discuss with your family and close friends.
Coping with cancer recurrence
The news of cancer recurrence brings several emotions. Every person has different thoughts and emotions on receiving this news. But it is very important to cope with all your emotions and stay strong for the treatment. Common emotions that you might need to deal with are:
Anger: It is fair and common to be angry about the recurrence of cancer. The anger can be towards your team for cancer treatment or yourself. At this point in time, all the efforts and pain that you faced during or after the treatment seems useless. However, the treatment given previously was given according to that situation.
Talk to someone about your feelings and get emotional support. Cancer patients who survived the recurrence of cancer can be perfect ones to give support. You can also opt for one-on-one counseling to discuss your feelings and situations.
Blaming doctors: “Cancer was gone, and I was supposed to live a happy life. But it is back because my doctor couldn’t treat it properly”. Thinking in this way is normal and accepted, it is a normal reaction. In this kind of situation, everyone wants to find a person to be blamed, and, the first person you think of is the doctor. But cancer is well known to be a tough condition and has been found to return even up to many years after treatment.
It’s important to remember that doctors always want to do their job well. it’s not the doctor’s or anyone’s fault if cancer recurs even after treatment. There are many factors for cancer recurrence. For example, when and where cancer recurs depends on the type of cancer. Some cancers have an expected pattern of recurrence. This also depends on disease biology which varies from patient to patient and cannot be predicted for all patients except when some features like tumour grade giving indirect cues.
You can try discussing your problems and concerns with the doctor so that he/she can clear your doubts. If you continue to have doubts, you can always consider taking a second opinion.
Anxiety and depression: It is common for people coping with recurrent cancer to have anxiety and depression. But if you are upset for a long time, it can cause severe anxiety and depression.
This kind of situation needs to be treated with medication. It might make it hard for you to follow the treatment schedules. Taking actions and improving physical symptoms may aid in making your mood better.
Even now, the coping skills that you used during the first treatment can be effective. In this condition, the support of friends and family is important.
In severe conditions, you must consult a doctor. Clinical depression and anxiety can be treated by medicines, physiotherapy, or both. These treatments make the person feel better and improve the quality of life.
Fear of death: Cancer can occur at any age and everyone in this phase has a fear of death. It is difficult for everyone to cope with the fear of death, but it can be more difficult for young people. Cancer recurrence comes with a more intense fear of death. There are chances of cancer recurrence to be more aggressive and hard to treat.
To get a real picture of your fear, consult your cancer team, and discuss all your concerns. Try exploring yourself and search for the purpose of your life. It aids in feeling better when there is no visible hope.
Hopelessness: Everyone has a different way to look and deal with the recurrence of cancer. Thinking about survival is normal for all.
You may feel more hopeless about the relapse of cancer than the first diagnosis of cancer. No doubt the situation is of more concern this time and the approach will be different. Discuss with your doctor and care team about the survival probability, which may help you to be more hopeful.
It is very important to cope with all the emotions coming with the recurrence of cancer. The support of family and friends is very important to bring hope and positivity in life. Try making positive changes in your lifestyle.
Most importantly, be transparent with your thoughts and concerns with your cancer care team to get a clear picture of your situation.
Support groups help many people cope with the emotional aspects of cancer by providing a safe place to share and work through feelings and challenges. They also allow people to learn from others facing similar situations.
Stay strong and positive.