Kashish Sharma
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Written By: Kashish Sharma | Updated : January 20, 2023 11:41 AM IST
If cancers are outcomes of diet and lifestyle issues, it's imperative to address those issues. Treating only cancers without addressing these issues will lead to sure shot recurrence, said expert.
From diagnosis to treatment, cancer can be a physically and emotionally exhausting journey. Experts say the worst thing about the disease is that it can re-occur. There is no surety that a person who once battled cancer cannot have it again. Cancer reoccurrence is a serious matter of discussion in medical science. It nullifies the emotional and physical struggles a person might have gone through while they fought it the first time. While advances in medical science have rendered several cancers curable and most cancers treatable, there are still not any ways in which one can predict if cancer would make a presence again or not.
Remission is a stage in cancer treatment where the signs and symptoms of the disease have lessened or have become undetectable. This state is not the same as cancer-free. This remission can be partial, complete or even spontaneous. For some, this remission stage can last forever and the person might never have cancer again but for others, it has to possibility to enter the recurrence stage. As per experts, recurrence depends on many factors such as the person's overall health, the kind and place of cancer, genetics, lifestyle and others.
The recurrence of cancer cannot be predicted. However, close monitoring of the body after the termination of treatment can ensure prevention to some extent. As per experts, the recurrence of cancer can be an emotionally overwhelming and frustrating experience for survivors who had already fought a difficult battle for the first time.
Dr Sanjay Verma, Director, Minimal Access, Bariatric, GI Surgery, GI Onco-surgery & General Surgery, (Fortis Escorts, New Delhi) explained how the recurrence of cancer can cause the same fear and emotional turmoil in the patient who might have encountered it earlier in their life. In his words, the news can be as fearful as it was the first time.
"When the disease recurs amongst survivors of cancer, it is accompanied by the same level of trepidation which the patient had at the initial time the disease was diagnosed. Some people report that a second cancer diagnosis can be more upsetting than the first, but there are strategies that can help."
Dr Verma explained that cancer recurrence might happen in spite of the best efforts to rid the body of the faulty cells because some of them might remain behind. These cells can grow and can cause symptoms again.
He said: "These cells could be in the same place where cancer first originated, or they could be in another part of your body. These cancer cells may have been dormant for a period of time. But for reasons that aren't understood, eventually, they continued to multiply, resulting in the reappearance of cancer."
The expert also informed that in rare instances, a patient may be diagnosed with new cancer that's completely unrelated to first cancer. This might be referred to as a second primary cancer. For instance, a person having cancer in their skin might develop cancer in their blood.
Dr Verma explained that cancer recurrence can happen in many ways. Sometimes it might be found in the same location as found previously, sometimes it can be found in a region proximal to the affected part and sometimes it can spread to other parts of the body. The expert explained the kinds with three categories-
1)Local recurrence. This means cancer reappears in the same place it was first found or very close by. Cancer hasn't spread to the lymph nodes or other parts of the body.
2)Regional recurrence. A regional recurrence occurs in the lymph nodes and tissue located in the vicinity of original cancer.
3) Distant recurrence. This refers to cancer that has spread to areas farther away from where the cancer was first located. This is called metastatic cancer.
According to the expert, the reasons for recurrence are not fully understood and there might be more than one factor involved. He said that genetics and lifestyle could give some suitable answers to why it might happen.
Dr Verma said: "A major cause of recurrence is genetics. When genetic mutations are accumulated over the course of time they lead to cancers. When cancer cells are destroyed by surgery, chemotherapy and radiotherapy, the tumours are controlled. However, the generic mutations persist and hence these lead to recurrences of the disease."
The expert not for a moment downplayed the role of maintaining a healthy lifestyle, and diet and controlling environmental factors that might play an important role in prevention.
He said: "If cancers are outcomes of diet and lifestyle issues, it's imperative to address those issues. Treating only cancers without addressing these issues will lead to sure shot recurrence. The same goes for environmental causes which if not changed will lead to recurrences of cancers."
According to the expert, sometimes a second diagnosis can be more overwhelming for the person who might have struggled with the disease earlier in their life. However, in some cases, these people might be more ready and aware of the treatment course than those who might encounter it for the first time.
"People with recurrences are worried about coping with another round of tests and treatments. But many people find they are better prepared because they have been through treatment before. This manifests as knowledge about cancer, which helps lessen fear and anxiety about the unknown and relationships with doctors, nurses, and other healthcare team members. Survivors have better knowledge of cancer treatments and side effects, including ways to manage side effects."
Acknowledging the emotional turmoil associated with a second diagnosis and how it might feel like a lost battle, Dr Verma shared an encouraging message for the survivors.
He said: "It is normal to be upset when you learn your cancer has come back. If this lasts a long time or affects your daily activities, ask your healthcare team about counselling. This may also be a good time to consider joining an in-person support group or online community. These are places where you can talk about your feelings and experiences with others in the same situation."
