If you have ever been diagnosed with cancer you know what a frightening experience it can be. You may also know that many cancers can be managed effectively, especially when they are detected early. Despite the great strides that have been made in treating cancer, fear that the cancer may return is always on the minds of survivors.

Generally speaking, there are several types of recurrences. Local recurrences are the growth of cancerous cells in the original site. This may mean that the cancer has spread or that the original therapy did not get rid of all of the cancer. Regional recurrences are the spread of the cancer to nearby sites; for instance, breast cancer may spread to the lymph nodes under the arm, under the breastbone or in the neck. Distant recurrences are also known as metastases. This is the spread of cancer to other organs, such as the lungs, bone, brain and liver. This is the most dangerous type of recurrence.

If cancer returns, it is not considered new cancer. This is true even if it appears in a different place in your body other than the original site of cancer. This is because, most often, recurring cancers have the same type of cancer cells as the original tumor regardless of where they are found. In rare instances, someone may develop a second cancer in which the cancer cells are of a different in type and origin.

There are some general symptoms that may indicate that cancer has recurred. These can include, but are not limited to:

• Formation of a new lump or swelling somewhere in the body.

• Bone pain, such as backaches

• Shortness of breath

• Lack of appetite, weight loss

• Neurological pain or weakness in the arms or legs

• A new onset of headaches

These symptoms are sometimes, but not always, associated with the return of cancer. Any changes in your health should be reported to your physician, who may perform various tests and scans to look for cancer that has returned.

The treatment of recurrent cancer varies according to the type of cancer you have and how widespread the recurrence is. Surgery is an option for some types of cancer, and most patients will receive some form of chemotherapy, radiation therapy or hormonal therapy. Many times, the drugs you receive for a recurrence are different from the drugs you received the first time. Today, there are many new drugs that extend the life of patients after a recurrence.

Patients with advanced cancer may want to consider entering a clinical trial to evaluate an experimental therapy. Contact one of the Health Alliance cancer centers listed below for more information.

A diagnosis of recurrent cancer is often more devastating psychologically than the initial diagnosis. Survivor programs, support groups and psychological and spiritual counseling are available at the Health Alliance cancer centers to help people re-adjust to living with a second diagnosis. Family and friends need to take their cues from the cancer patient -- be available and ready to talk openly about the illness, respect the patient’s need for quiet time and, as much as possible, maintain a sense of normalcy in life.

If you’d like more information on cancer care, including information about cancer treatment, screening, prevention, supportive care and clinical trials, please contact one of our facilities.