Managing Recurrence

When the fear of recurrence becomes reality, it can bring up many questions including:

• Can this be treated or cured-what are my options?
• Am I up for more treatment?
• How do I tell my family and friends? 
• Was my original treatment a waste?
• What do I do now?   

Cancer coming back also brings up many different emotions. You may feel fearful, shocked, angry, overwhelmed, and out of control. Turn to those who gave you support during your first experience with cancer. Don't hesitate to seek out help and support from social workers, therapists, and support groups. Both in-person or online, family, friends, and clergy can all provide support during a recurrence.

Keep in mind, you have done this before. You know much more now than you did at the time of your original diagnosis. Use that knowledge to guide your treatment decisions and help you put into place the support you need to get through this battle.

A recurrence can mean different things to different people- each situation is unique. You may want to start aggressive treatment right away. Maybe this isn't your first recurrence. Perhaps you just aren't sure you want to go through more chemotherapy or surgery. There is no "right" way to respond. Just as the initial treatment decisions are a balance of pros and cons, so is treating- or not treating- a recurrence.

Ask your treating physician what are all of your options and what treatment does he or she recommend and why? With the help of your support people, weigh the pros and cons of your treatment options. Consider your goals and how each treatment will impact them and your quality of life. You may want to consider seeing another physician and get a second opinion. Getting a second opinion does not mean you have to switch doctors; you are just getting input from another perspective. You may also want to research what clinical trials are available to you.

While surgery, chemotherapy, or a clinical trial of a new medication may be the best option for some, others may feel that they don't want to pursue aggressive treatments again. And that is okay. It may not be a decision family and friends will understand, but it is the patient's decision. Read more about stopping treatment and the philosophy of hospice care.

Palliative care may be an option for some who still wish to pursue active treatment but could use additional help with managing symptoms such as pain, shortness of breath, nausea, etc. Palliative care is a medical specialty (like oncology or cardiology) focused on the relief of pain, stress, and other debilitating symptoms of serious illness. Palliative care differs from hospice in that it can be used at the same time as curative treatment. Not all hospitals have palliative care specialists. Visit getpalliativecare.org to find a specialist in your area.

Some good resources for dealing with a recurrence:

• NCI publication, When Cancer Returns
• ACS resource, Coping with Cancer Recurrence