You likely feel excited and relieved if your lung cancer is in remission. But there may also be a hint of concern that it will return. While it would be wonderful to have your cancer gone for good, there are, unfortunately, no guarantees. Even with the advancements in lung cancer treatment, there is always a chance that your lung cancer could begin to grow again in the future.
Because of this, going to every oncology follow-up appointment is crucial. During these visits, your oncologist will carefully monitor any changes. To do this, they will use recent blood tests to look for tumor markers as well as imaging tests to look for signs of new cancer growth. It’s important to be hopeful, but we also want you to be aware of signs that could indicate your lung cancer has come back.
What is Recurrent Lung Cancer?
Lung cancer that has come back after treatment is called recurrent lung cancer. It’s important to understand that remission is not the same as being cured. It just means that there are no detectable signs of cancer. The length of lung cancer remission varies among patients. It could be months, years, or even the rest of your life.
Whether your lung cancer returns depends on many different factors, including the lung cancer type and stage at which it was found.
- Patients with small cell lung cancer (SCLC) are more likely to experience a recurrence than those diagnosed with non-small cell lung cancer (NSCLC). This is most often within a year or two of the first diagnosis.
- Recurrence in patients with non-small cell lung cancer is based on the stage in which it was found:
- Stage I: 5%-19% of patients have a recurrence
- Stage II: 11%-27% of patients have a recurrence
- Stage III: 24%-40% of patients have a recurrence
Non-small cell lung cancer recurrence is most common within five years after diagnosis.
Prognosis is Affected By the Type of Recurrence
There are three main ways in which lung cancer can recur, with each location determining how it is categorized.
- Local recurrence is when the cancer has returned close to its point of origin.
- Regional recurrence is when the cancer returns to the lymph nodes or the surrounding tissues of your initial cancer.
- Distant recurrence is when the lung cancer has made its way to an area distant from the original site of cancer, such as in the brain, bones, adrenal glands, or liver.
If your lung cancer returns, your oncologist will evaluate which of these categories you’re in. Doing this involves another round of tests similar to the ones at the time of diagnosis. Various factors, including whether the recurrence is local, regional, or distant, will determine a person’s prognosis.
In general, patients diagnosed with recurrent NSCLC have a higher five-year survival rate compared to those diagnosed with recurrent SCLC.
Signs of Lung Cancer Recurrence
You may be the best source of information for your doctor when it comes to noticing changes. While regular oncology checkups are important, you should talk to your oncologist immediately if you notice any of the following between visits.
- Persistent cough
- Coughing up blood
- Visual disturbances and dizziness
- Wheezing, difficulty breathing, shortness of breath
- Unexpected weight loss
- Chronic fatigue
There are also some less common symptoms of lung cancer you might notice. Learn more about these in our blog: 16 Unexpected Lung Cancer Symptoms You Should Know About.
Keep in mind that not all patients will experience the same signs of lung cancer recurrence, as symptoms are usually reflective of where in the body the cancer is growing. Cancer that has spread to a distant location, such as the brain, bones, or liver, might produce additional symptoms, including:
- Lack of coordination
- Pneumonia
- Confusion
- Itchiness
- Deep pain in the chest, back, arms, legs, or shoulders
- Weakness on one side of the body
- Abdominal pain
- Jaundice or yellowing of the skin and eyes
Where the cancer has returned can influence the symptoms you experience. For example, lung cancer spreading to the brain could cause confusion and poor coordination, while lung cancer in the liver could result in jaundice. While something other than cancer could be causing these symptoms, it’s best to see a doctor to get a proper diagnosis.
Read more in our blog about the symptoms of lung cancer.
What Causes Lung Cancer to Recur?
Even when lung cancer has gone into remission, there can be lingering cancer cells that go undetected on a scan. Over time, these cells can develop into localized cancer or metastasize throughout the body. Genetics or lifestyle factors can also increase the risk of cancer coming back.
Lowering Your Risk of Lung Cancer Recurrence
Certain risk factors can put you at a higher risk of developing lung cancer in your lifetime, which include:
- Smoking
- Inhaling secondhand smoke
- Family history of lung cancer
- Air pollution
- Exposure to radon or asbestos
- Arsenic in your drinking water
- Previous radiation therapy to lungs
While you should know all the risks associated with lung cancer and its recurrence, smoking is the most significant. If you smoke, the best thing you can do is quit. If you are exposed regularly to secondhand smoke, find ways to limit your exposure. Taking positive action can reduce the chances of a lung cancer recurrence.
Read more in our blog about smoking and lung cancer.
Treatment Options for Lung Cancer Recurrence
The RMCC lung cancer care team will evaluate your unique situation and make treatment recommendations based on your preferences.
Treatments for lung cancer recurrence can include:
- Targeted therapy is a relatively new category of treatment available to recurrent non-small cell lung cancer patients. Your oncologist may run biomarker (genomic) testing on the tissue collected to confirm the recurrent cancer diagnosis. The tests are looking for specific genetic mutations that can cause the lung cancer to grow. Specific targeted therapy drugs are now available to patients for some of the more common genetic mutations. Learn more in our blog: Lung Cancer Gene Mutations: What Are They and How Do They Affect Treatment?
- Chemotherapy is a standard course of treatment for lung cancer recurrence. Because recurrent lung cancer can mutate and respond differently, your lung cancer specialist may recommend a different chemotherapy drug.
- Radiation therapy can be used to reduce the size of tumors that have developed in other areas of the body when lung cancer recurs. It may also be used to relieve symptoms caused by cancer (palliative radiation therapy).
Read more in our blog about when radiation therapy is used to treat lung cancer.
Surgery is not a common approach to treating recurrent lung cancer. However, it can sometimes be used if you have a localized tumor.
Related blog: Advancements in Lung Cancer Treatment Provide Hope for Our Patients
Recurrent Lung Cancer Treatment in Colorado
If you or a loved one has been diagnosed with recurrent lung cancer, the specialists at Rocky Mountain Cancer Centers are here to help. We are committed to providing comprehensive care and cutting-edge lung cancer treatments. Schedule a consultation with one of our lung cancer doctors in Colorado, including the Denver area, Colorado Springs, Boulder, and throughout the Front Range.
