What Is Cancer Recurrence?

Sometimes, cancer can come back after treatment. When it does, it's called cancer recurrence. The cancer might come back in the same place it first started, or it might come back somewhere else in the body. Even if the cancer comes back in a new part of the body, it’s still named after the part of the body where it started.

It’s not possible to say how likely a cancer is to recur, but cancer is harder to treat and more likely comes back if it is:

• Fast growing
• More advanced or widespread

What are the types of recurrence?

There are different types of cancer recurrence:

• Local recurrence means that the cancer has come back in the same place it first started.
• Regional recurrence means that the cancer has come back in the lymph nodes near the place it first started.
• Distant recurrence means the cancer has come back in another part of the body.

If your cancer recurs, your cancer care team can give you the best information about what type of recurrence you have and what it means, if you'd like to know. If your cancer care team thinks this could be a second cancer (a different type of cancer), they can talk with you about testing to find out what is really happening. They can also talk with you about different options for treatment and your outlook (prognosis).

Describing cancer and cancer recurrence

What does it mean if the doctor says, “The cancer is controlled”?

A doctor may use the term “controlled” or “stable” if your tests or scans show that the cancer is still there, but it’s not changing over time. Controlled or stable means that the tumor doesn’t look like it’s growing. Some tumors can stay the same for a long time, even without any treatment and are watched to be sure that they don’t start growing again.

What does it mean if the doctor says, “The cancer has progressed”?

If the cancer does grow, your doctor might say that the cancer has progressed. Ask your doctor for details if you’d like to know more about how much it has  grown or spread.

What’s the difference between recurrence and progression?

Sometimes it’s hard to tell the difference between recurrence and progression. Recurrence means the cancer has come back. Progression means the cancer is growing or spreading without ever having gone away completely.  For example, if cancer has not been found for a short time before it comes back, it was probably not completely gone. Is this a recurrence or progression? Chances are this is not really a recurrence. In this case, it’s likely one of these things happened:

• The surgery done to take out the cancer didn’t get all of it. Tiny clusters of cancer cells that couldn’t be seen or found on scans or other tests were left behind. Over time they grow large enough to show up on scans or cause symptoms. These cancers tend to be very aggressive (fast-growing and quick to spread).
• The cancer has become hard to treat or resistant to treatment. Cancer cells can become resistant to treatment just like germs can become resistant to antibiotics. This means chemotherapy or radiation may have killed most but not all of the cancer cells. These cancer cells can then grow and show up again.

If the cancer comes back a short time after it was gone, it is important to talk about a care plan with your cancer care team. There’s no standard length of time to decide if it’s recurrence or progression. But most doctors consider recurrence to be cancer that comes back after you’ve had no signs of it for at least a year.

Response and remission

Complete response or remission

When a treatment completely gets rid of all tumors that were seen on a test or were measured in some way, it’s called a complete response or complete remission. A complete response or complete remission does not mean the cancer has been cured. It means the cancer is not seen on any tests.

Partial response or remission

In general, a partial response (or partial remission) means the cancer responded to treatment, but still has not gone away. A partial response is most often defined as at least a 50% reduction in a tumor that can be measured.) The reduction in tumor size must last for at least a month to qualify as a response. Again, you can ask for more details about the kind of response to treatment the doctor sees, and how long it lasts.