Cancer recurrence

Short description: Return of cancer after treatment

Cancer recurrence or recurrent cancer is when a patient's cancer returns after treatment.[1] Recurrence rates are unavailable for all types of cancer and not all available data is up to date.[2] To determine the type of recurrence, the person with cancer will go though many of the same tests they had when they were first diagnosed. The doctor may refer to this assessment of the patient’s cancer as restaging.[1] In rare cases a person may be diagnosed with a new type of a cancer.[3]

## Contents

* 1 Types
* 1.1 Local recurrence
* 1.2 Regional recurrence
* 1.3 Distant recurrence
* 2 In various types of cancer
* 2.1 Ewing sarcoma
* 2.2 Testicular cancer
* 2.3 Prostate cancer
* 2.4 Osteoblastoma
* 2.5 Glioblastoma
* 2.6 Renal cell carcinoma
* 2.7 Vulvar cancer
* 2.8 Pancreatic cancer
* 2.9 Leukemia
* 2.10 Ovarian cancer
* 2.11 Breast cancer
* 2.12 Bladder cancer
* 2.13 Lung cancer
* 2.14 Rectal cancer
* 2.15 Oral cancer
* 2.16 Melanoma
* 3 Effect on patients
* 3.1 Fear of cancer recurrence
* 4 References

## Types

### Local recurrence

Local recurrence is when cancer comes back in the same place it first appeared.[4]

### Regional recurrence

Regional recurrence is when cancer comes back in lymph nodes near the spot it first appeared.[4]

### Distant recurrence

Distant recurrence is when cancer comes back in another part of the body.[4]

## In various types of cancer

This section needs expansion with: The sources currently cited in this section say a lot more on the topic. There are also many more cancer types and in depth sources on recurrence in these cancer types. You can help by adding to it. (September 2021)

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### Ewing sarcoma

Recurrence for patients with ewing sarcoma is about 70% after 2 years of the first diagnosis.

About two thirds experience recurrence in distant areas, typically the in bones or the lungs this is common for those with metastasis. While local recurrence occurs in one-fifth of patients.[5]

### Testicular cancer

According to the National Health Service the recurrence rate for testicular cancer is low.[6]

### Prostate cancer

In prostate cancer, about 20% to 30% of men will have a recurrence after 5 years of the first treatment.[7]

### Osteoblastoma

95% of cases of Osteoblastoma experience recurrence within 2 years after surgery.[8][needs update]

### Glioblastoma

Glioblastoma has high recurrence rate with about 100% of patients dying from recurrent tumors. As of 2021 there is no effective and no universal standard of treatment for recurrent Glioblastoma.[9]

There are not many studies on recurrence for Glioblastoma. Mainly due to not all recurrent tumors being operable, making access to recurrent tumor tissue short.[10]

### Renal cell carcinoma

Renal cell carcinoma has a recurrence rate of 20% to 40% after nephrectomy. Recurrences after 30 years of nephrectomy have been reported. However, there have been reports showing that recurrence can happen for 43% of patients within 1 year, 70% within 2 years, 80% within 3 years, and 93% within 5 years.[11]

### Vulvar cancer

In vulvar cancer, recurrence occurs in 24% of cases after surgery.[12]

More than 80% of recurrences happen after 2 years of treatment and more than 50% of them are local type.[13]

### Pancreatic cancer

Recurrence rates in pancreatic cancer is as high 95%.[14]

In this form of cancer, local recurrence after surgery with curative intent is regularly observed within 2 years for a majority of patients.[15]

### Leukemia

When leukemia comes back it is also called relapse.[16] Recurrence has been reported in 60% of patients with leukemia.[17] In children with acute leukemia who are cancer-free after five years, the cancer is unlikely to return.[18]

### Ovarian cancer

Cancer recurrence occurs in 7 out of 10 women with ovarian cancer.[19] The Ovarian Cancer Research Alliance states that people diagnosed with stage 1 have a 10%, those diagnosed with stage 2 have 30%, stage 3 have 70% to 90%, and stage 4 have a 90% to 95% chance of recurrence.[20]

### Breast cancer

Recurrent breast cancer may occur in months or years after treatment.[21] Breast cancer has a 3% to 15% chance of recurrence in 10 years with treatment.[22] A 2008 study stated that breast cancer has a 7% to 13% recurrence rate within five years.[2]

People with obesity or are under 35 years of age have a higher risk of breast cancer coming back.[21] The cancer stage and cancer type can also increase the risk of recurrence. Like both inflammatory breast cancer and triple-negative breast cancer have higher chances of coming back.[22]

Most kinds of local recurrence for breast cancer can be treated with early detection and curative intent.[23]

### Bladder cancer

Recurrence rates for bladder cancer are around 50% to 80% after first treatment.[24] Patients with T1 cancer are at a higher risk of cancer coming back. Intravesical therapy can help prevent recurrence.[25]

### Lung cancer

Lung cancer is most likely to return in patient after 5 years they were diagnosed. For people with NSCLC, the chance of a recurrence depends on what stage of cancer they have.[26] Cancer comes back in 30% to 55% of patients with NSCLC.[27] Most people with SCLC type will have a recurrence in a year or two. When it comes back, it typically spreads faster.[26]

### Rectal cancer

In rectal cancer local recurrence rates are from 3.7% to 50%.[28] As of 2016 there is no standard treatment regimen for the patients with the local recurrence type of rectal cancer.[29]

### Oral cancer

Oral cancer has a high recurrence rate. Local and regional recurrences made up 90% of treatment failures after surgery and radiotherapy.[30]

### Melanoma

Melanoma has a 2% to 3% rate of local recurrence.[31]

Few recurrences happen with in 5 years and a majority of recurrences is locoregional type.[32]

## Effect on patients

### Fear of cancer recurrence

Patients whose cancer is in remission may have to deal with the uncertainty that at any time their cancer could return. After the first treatment is over, anxiety is higher among people who have survived cancer than among people who have not had cancer.[33] This anxiety regarding the cancer's return is called fear of cancer recurrence.[34]

## References

1. ↑ 1.0 1.1 "Recurrent Cancer - National Cancer Institute" (in en). 2016-01-18. https://www.cancer.gov/types/recurrent-cancer.
2. ↑ 2.0 2.1 Watson, Ronald Ross; Preedy, Victor R.; Zibadi, Sherma (2013-10-26) (in en). Polyphenols in Human Health and Disease. Academic Press. pp. 192. ISBN 978-0-12-398467-8. https://books.google.com/books?id=9T4TAAAAQBAJ&q=Chapter+16+-+Food+and+Supplement+Polyphenol+Action+in+Cancer+Recurrence&pg=PA190.
3. ↑ "How to cope when your cancer comes back" (in en). https://www.mayoclinic.org/diseases-conditions/cancer/in-depth/cancer/art-20044575.
4. ↑ 4.0 4.1 4.2 "What Is Cancer Recurrence?" (in en). https://www.cancer.org/treatment/survivorship-during-and-after-treatment/understanding-recurrence/what-is-cancer-recurrence.html.
5. ↑ Van Mater, David; Wagner, Lars (2019-03-27). "Management of recurrent Ewing sarcoma: challenges and approaches". OncoTargets and Therapy 12: 2279–2288. doi:10.2147/OTT.S170585. ISSN 1178-6930. PMID 30988632.
6. ↑ "Testicular cancer - Treatment" (in en). 2018-03-02. https://www.nhs.uk/conditions/testicular-cancer/treatment/.
7. ↑ "Prostate Cancer Prognosis" (in en). https://www.hopkinsmedicine.org/health/conditions-and-diseases/prostate-cancer/prostate-cancer-prognosis.
8. ↑ Adler, Claus-Peter (1999-12-09) (in en). Bone Diseases: Macroscopic, Histological, and Radiological Diagnosis of Structural Changes in the Skeleton. Springer Science & Business Media. pp. 270. ISBN 978-3-540-65061-4. https://books.google.com/books?id=TyBMs-pc7g0C&q=blastoma+recurrence&pg=PA270.
9. ↑ Arbab, Ali Syed (2021-03-05) (in en). New Targeting in The Reversal of Resistant Glioblastomas. Academic Press. pp. 1. ISBN 978-0-12-823276-7. https://books.google.com/books?id=6H0eEAAAQBAJ&q=glioblastoma+recurrence.
10. ↑ Somasundaram, Kumaravel (2017-06-29) (in en). Advances in Biology and Treatment of Glioblastoma. Springer. pp. 46. ISBN 978-3-319-56820-1. https://books.google.com/books?id=vnIqDwAAQBAJ&q=glioblastoma+recurrence&pg=PA46.
11. ↑ Chin, Arnold I; Lam, John S; Figlin, Robert A; Belldegrun, Arie S (2006). "Surveillance Strategies for Renal Cell Carcinoma Patients Following Nephrectomy". Reviews in Urology 8 (1): 1–7. ISSN 1523-6161. PMID 16985554.
12. ↑ Salom, Emery M.; Penalver, Manuel (April 2002). "Recurrent vulvar cancer". Current Treatment Options in Oncology 3 (2): 143–153. doi:10.1007/s11864-002-0060-x. ISSN 1527-2729. PMID 12057077. https://pubmed.ncbi.nlm.nih.gov/12057077/.
13. ↑ Eifel, Patricia; M.D, Patricia J. Eifel; Levenback, Charles (2001) (in en). Cancer of the Female Lower Genital Tract. PMPH-USA. pp. 288. ISBN 978-1-55009-107-6. https://books.google.com/books?id=1nzyfeakIXcC&q=vulvar+cancer+recurrence&pg=PA288.
14. ↑ Lee, Jong-chan; Ahn, Soyeon; Cho, In Kuk; Lee, Jongchan; Kim, Jaihwan; Hwang, Jin-Hyeok (2018-04-01). "Management of recurrent pancreatic cancer after surgical resection: a protocol for systematic review, evidence mapping and meta-analysis" (in en). BMJ Open 8 (4): e017249. doi:10.1136/bmjopen-2017-017249. ISSN 2044-6055. PMID 29632079. PMC 5892773. https://bmjopen.bmj.com/content/8/4/e017249.
15. ↑ Heye, Tobias; Zausig, Nicola; Klauss, Miriam; Singer, Reinhard; Werner, Jens; Richter, Götz Martin; Kauczor, Hans-Ulrich; Grenacher, Lars (2011-03-07). "CT diagnosis of recurrence after pancreatic cancer: Is there a pattern?". World Journal of Gastroenterology 17 (9): 1126–1134. doi:10.3748/wjg.v17.i9.1126. ISSN 1007-9327. PMID 21448416.
16. ↑ "Living as an Acute Lymphocytic Leukemia (ALL) Survivor" (in en). https://www.cancer.org/cancer/acute-lymphocytic-leukemia/after-treatment/follow-up.html.
17. ↑ Neth, R.; Gallo, R. C.; Greaves, M. F.; Moore, M. A. S.; Winkler, K. (2012-12-06) (in en). Modern Trends in Human Leukemia V: New Results in Clinical and Biological Research Including Pediatric Oncology. Springer Science & Business Media. pp. 13. ISBN 978-3-642-68761-7. https://books.google.com/books?id=5VzrCAAAQBAJ&q=leukemia+recurrence&pg=PA13.
18. ↑ "Survival rates for childhood leukemia". 2 March 2014. http://www.cancer.org/cancer/leukemiainchildren/overviewguide/childhood-leukemia-overview-survival-rates.
19. ↑ Marks, Julie. "When Cancer Comes Back" (in en). https://www.webmd.com/cancer/when-cancer-comes-back-recurrence.
20. ↑ "Ovarian Cancer Recurrence and Treatment" (in en-US). https://ocrahope.org/patients/about-ovarian-cancer/recurrence/.
21. ↑ 21.0 21.1 "Recurrent breast cancer - Symptoms and causes" (in en). https://www.mayoclinic.org/diseases-conditions/recurrent-breast-cancer/symptoms-causes/syc-20377135.
22. ↑ 22.0 22.1 "Breast Cancer Recurrence: Symptoms & Treatment". https://my.clevelandclinic.org/health/diseases/8328-breast-cancer-recurrence.
23. ↑ Hodler, Juerg; Kubik-Huch, Rahel A.; Schulthess, Gustav K. von (2019-02-19) (in en). Diseases of the Chest, Breast, Heart and Vessels 2019-2022: Diagnostic and Interventional Imaging. Springer. pp. 167. ISBN 978-3-030-11149-6. https://books.google.com/books?id=SNaIDwAAQBAJ&q=Local+recurrence.
24. ↑ Bassi, PierFrancesco; Pagano, Francesco (2007-07-29) (in en). Invasive Bladder Cancer. Springer Science & Business Media. pp. 197–198. ISBN 978-1-84628-377-2. https://books.google.com/books?id=By39wpr0U0wC&q=Regional+recurrence.
25. ↑ Ather, M. Hammad (2017-04-12) (in en). Bladder Cancer: Management of NMI and Muscle-Invasive Cancer. BoD – Books on Demand. pp. 3–4. ISBN 978-953-51-3077-2. https://books.google.com/books?id=FvmODwAAQBAJ&q=Bladder+cancer+recurrence.
26. ↑ 26.0 26.1 "When Lung Cancer Comes Back" (in en). https://www.webmd.com/lung-cancer/guide/when-lung-cancer-comes-back.
27. ↑ Uramoto, Hidetaka; Tanaka, Fumihiro (August 2014). "Recurrence after surgery in patients with NSCLC". Translational Lung Cancer Research 3 (4): 242–249. doi:10.3978/j.issn.2218-6751.2013.12.05. ISSN 2218-6751. PMID 25806307.
28. ↑ "How common is the recurrence of rectal cancer and what is the prognosis?" (in en). https://www.medscape.com/answers/281237-100615/how-common-is-the-recurrence-of-rectal-cancer-and-what-is-the-prognosis.
29. ↑ Nieder, Carsten; Langendijk, Johannes (2016-10-25) (in en). Re-Irradiation: New Frontiers. Springer. pp. 40. ISBN 978-3-319-41825-4. https://books.google.com/books?id=BRBVDQAAQBAJ&q=head+and+neck+cancer+recurrence.
30. ↑ Silva, Sabrina; Hier, Michael; Mlynarek, Alex; Kowalski, Luiz; Alaoui-Jamali, Moulay A. (2012). "Recurrent Oral Cancer: Current and Emerging Therapeutic Approaches". Frontiers in Pharmacology 3: 149. doi:10.3389/fphar.2012.00149. ISSN 1663-9812. PMID 23060791.
31. ↑ Riker, Adam I. (2018-06-06) (in en). Melanoma: A Modern Multidisciplinary Approach. Springer. pp. 351. ISBN 978-3-319-78310-9. https://books.google.com/books?id=1fVeDwAAQBAJ&q=melanoma+recurrence&pg=PA351.
32. ↑ Borden, Ernest C. (2002-04-03) (in en). Melanoma: Biologically Targeted Therapeutics. Springer Science & Business Media. pp. 28. ISBN 978-1-59259-159-6. https://books.google.com/books?id=dGUrBgAAQBAJ&pg=PA28&dq=melanoma+recurrence&hl=en&newbks=1&newbks_redir=0&source=gb_mobile_search&sa=X&ved=2ahUKEwjluPL4ssXzAhVBITQIHZhdDtEQ6AF6BAgKEAM.
33. ↑ "Depression and anxiety in long-term cancer survivors compared with spouses and healthy controls: a systematic review and meta-analysis". The Lancet. Oncology 14 (8): 721–32. July 2013. doi:10.1016/S1470-2045(13)70244-4. PMID 23759376.
34. ↑ "A qualitative exploration of fear of cancer recurrence (FCR) amongst Australian and Canadian breast cancer survivors". Supportive Care in Cancer 24 (5): 2269–2276. May 2016. doi:10.1007/s00520-015-3025-x. PMID 26581900.

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