After completing treatment for cancer, many people have the fear of 'Will it come back?' It's very common. If you have had colorectal cancer and it comes back after treatment, your doctor will call it ' recurrent colorectal cancer'. It's true that this can be a big burden to hear. But don't worry. Let's talk about everything clearly and simply.
There are several ways that cancer can recur.
When it comes to cancer coming back, there are several ways it can happen. Your doctor may use these terms when explaining this, so it's important to have a little understanding of these.
Simply put, this classification is based on where the cancer recurs.
| Recurrence Type | Simply meaning |
|---|---|
| Local Recurrence | This means that the cancer comes back in the exact same place where the cancer was before, that is, in the colon or rectum. |
| Regional Recurrence | What happens here is that the cancer comes back in the lymph nodes that are close to where the cancer was before. |
| Distant Recurrence | This is the name given to when cancer has come back in a distant part of the body, for example, in the liver, lungs, or brain. The doctor may also call this "Metastatic." |
Sometimes it is difficult to tell whether this is a recurrence or an advanced cancer. This will be determined over time. Typically, we talk about recurrent cancer after at least a year of treatment. However, if the cancer comes back after a short period of time, such as a few months, it often means that the original treatment did not completely eliminate the cancer cells.
What are the symptoms of this?
Often, the symptoms of colon cancer that come back can be similar to the symptoms you had when you first had the cancer. You may remember the discomfort you felt at that time.
These are the symptoms that can be seen in general:
- Stomach ache or pain (Belly pain)
- Constipation or diarrhea
- Weight loss without any reason
- Feeling more tired than usual (Tiredness)
- Loss of appetite
Depending on where the cancer has spread, other symptoms may also occur, such as:
- Pelvic or back pain
- Trouble breathing
But it's important to remember this too. Sometimes, the cancer can come back without any symptoms . That's why it's so important to continue to go to clinics (follow-up visits) according to the schedule prescribed by your doctor after cancer treatment.
How do you know for sure if the disease has returned?
Identifying this condition as early as possible greatly increases the chances of cure . Most often, your doctor will detect this during follow- up visits after your treatment. These tests are usually done every 3-6 months.
At these clinics, the doctor can do things like:
- Physical Exam: You will be given a complete physical examination.
- Asking about symptoms: Talk to your doctor about any new discomfort you're feeling. Don't hide it, even if it's small.
- Blood Test: This specifically checks the level of a protein called CEA (Carcinoembryonic Antigen) . Although not always, in some people, CEA levels increase when the cancer returns.
- Endoscopy: A procedure in which a small, flexible tube with a camera attached is passed into the large intestine to examine the inside.
- Colonoscopy: This is a test similar to an endoscopy, but it is more suitable for looking for new tumors rather than for cancer that has returned.
- Biopsy: This is the best way to confirm if cancer is suspected. In this procedure, a very small piece of tissue is removed from the suspicious lump and examined under a microscope to determine if cancer cells are present.
- Imaging Tests (such as CT, MRI): Your doctor may recommend tests such as a CT scan (Computed Tomography) to see if the cancer has spread to other parts of the body and to what extent.
What are the treatments available?
Before suggesting a treatment plan for you, your doctor will consider several factors.
- How long has it been since the cancer first appeared?
- Where has the cancer recurred? (Local, Regional or Distant?)
- Has the cancer spread?
- How is your overall health?
All of this will determine the treatment method that is most suitable for you.
In particular, remember that cancer cells may have become 'resistant' to previously used chemotherapy drugs. Therefore, the doctor may choose a different type of chemotherapy drug this time.
Fortunately, there are many treatment options available today.
- Surgery: If possible, the main treatment is to surgically remove the reoccurring tumor.
- Chemotherapy: Combinations of different drugs may be given. Sometimes the strengths may be changed, and sometimes the drugs may be stopped for a while and then started again.
- Radiation: If you did not receive radiation treatment previously, you may be given radiation treatment along with surgery and chemotherapy this time.
- Targeted Therapy: These are newer types of drugs. They target cancer cells directly and stop them from growing. Their side effects are different from regular chemotherapy. However, these drugs do not work for all types of cancer.
Take-Home Message
- After cancer treatment , be sure to go to follow-up visits as prescribed by your doctor. That's the best way to detect a recurrence early.
- Don't ignore any new changes or symptoms in your body (stomach aches, weight loss, excessive fatigue) and tell your doctor immediately.
- The recurrence of cancer does not mean that everything is over. Today, there are very advanced and successful treatments . It is also very important to think positively.
- It's normal to feel fear, anxiety, and sadness at a time like this. Talk openly about it with your family, a trusted friend, or your doctor. Getting emotional support is also part of the treatment.
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