Colorectal cancer recurrence

Cancer recurrence is when a cancer is found again after a period of time when the cancer could not be detected (remission).

With colorectal cancer, you may have not symptoms at all, or your recurrence symptoms may be the same as your original symptoms, such as:

• abdominal pain
• bloody stools
• weight loss
• diarrhea
• constipation

A colonoscopy may also reveal a recurrence, which is why it’s important to stay on schedule with your screening tests and other follow-up appointments.

The sooner a recurrence is diagnosed, the better the chances are for survival.

Recurrent colorectal cancer might come back in the same place it was originally, or it might come back in another area of the body.

Recurrence is divided into three categories:

• Local recurrence. The cancer reappears in the same place or nearby the place it was found. The cancer hasn't spread to the lymph nodes or other parts of the body.
• Regional recurrence. A regional recurrence appears in the lymph nodes and tissue located near the area of your original cancer.
• Distant recurrence. Cancer has spread to areas farther away from where your cancer was first located. In colorectal cancer, this may be the liver, lungs, or brain. This is called metastatic cancer.

When colorectal cancer spreads to a new area of the body, it’s still called colorectal cancer. For example, colorectal cancer may come back in the liver, but it is still colorectal cancer, not liver cancer. The cancer in the lungs will be treated as colorectal cancer.

Treatment for recurrent colorectal cancer is based on many things, including:

• Location of the cancer
• Other health issues
• Individual preferences

The main treatments used are surgery, chemotherapy, or radiation, or a combination of any of these. Other treatments such as liver directed therapy or immunotherapy may be recommended.

Joining a clinical trial may also be an option, where you may have access to more recently developed treatments and experimental medications.

Talk to your care team about clinical trials that are appropriate for you.

colorectal cancer recurrence can bring back many of the difficult emotions you felt when you were originally diagnosed.

This time around, however, can be different because:

• You are better prepared and know much more about colorectal cancer than the first time you faced it.
• You know which coping strategies work for you such as physical activity, spending time with friends and family, and meditation.
• You have a care team that you know -- you are going back to familiar faces and people who know you.
• New treatments are rapidly becoming available.

In this podcast, oncology social worker and 2-time breast cancer survivor Hester Hill Schnipper discusses ways to cope with the fear of recurrence.