Some mesothelioma patients who achieve remission will eventually have a recurrence, which is when cancer returns after a period of being undetectable. Recurrence is not a worry for most mesothelioma patients because remission is rare. Those who beat mesothelioma must be aware of the possibility of recurrence and work with their medical teams to prevent it.
Understanding Recurrence
A cancer recurrence means the same cancer has returned after a period when it wasn’t detected. If you are diagnosed with early-stage mesothelioma that is treated aggressively until it can no longer be found in your body, that is called complete remission; however, you may not be completely cured because cancer could recur.[1]
A recurrence does not have to appear in the same part of the body where the cancer began. For example, if you recover from pleural mesothelioma, cancer could reoccur in the abdominal cavity. Your cancer would still be referred to as pleural but recurrent.
Cancer recurrence may be local, meaning it is present in the same part of the body. It is considered regional if it returns to lymph nodes close to where it originated. A distant recurrence is when the cancer returns to a completely different part of the body.[1]
What Is the Difference Between Recurrence and Progression?
Progression is another cancer care term that may be confused with recurrence. A return of cancer can only be called a recurrence after cancer cells are eliminated from the body or can not be detected. Progression describes cancer that has not been fully cured and gets worse.[1]
Complete remission from mesothelioma is so rare that this can be confusing. Treatment may result in partial remission, meaning that half or more of a tumor has been eliminated.
A partial remission may make you feel like you are healing; however, because the cancer has not been thoroughly eliminated, if it worsens, it has progressed, not recurred.
How Do You Treat Mesothelioma Recurrence?
Aggressive, multi-modal treatment is the best way to prevent mesothelioma recurrence. Several treatments can eliminate cancer, including surgery, chemotherapy, and radiation.
One study of mesothelioma patients found good survival rates after extrapleural pneumonectomy (EPP), the most aggressive (and dangerous) surgery for mesothelioma.[2]
EPP removes nearly all the tissue from one side of the chest cavity, including the lung, pleura, and part of the diaphragm, which can be artificially reconstructed.
The surgeon may also remove lymph nodes during this procedure. Some patients in the study avoided recurrence for longer than patients unable to undergo the procedure with chemotherapy and radiation.
Some clinical trials specifically recruit patients with recurrent mesothelioma to study new medications or therapies. If you experience a recurrence, talk to your doctors about the possibility of enrolling in a trial to access new treatments.
Stories of Survival
Although stories of survival are rare, some people have lived years after a mesothelioma diagnosis, some with recurrences and others cancer-free.
One patient developed peritoneal mesothelioma, which normally reduces life expectancy to months. This patient survived for nineteen years with no recurrences after initial treatment.[3]
This is practically unheard of with mesothelioma. There are also stories of patients going six and twelve years after diagnosis and treatment without a recurrence.
Controlling Mesothelioma
As treatments for this difficult cancer improve, more patients will face recurrence. As with many types of cancer, once a cure is found, recurrence becomes a common factor in long-term survival.
Mesothelioma specialists typically talk about controlling the disease rather than curing it. While a few people have been lucky, researchers don’t fully understand why.
However, advancements in mesothelioma treatment allow doctors to control the disease in their patients. They can help their patients live longer with the disease, which is a major improvement.
How to Cope with a Recurrence
As recurrences become more common in mesothelioma, patients must learn to cope with them. When your cancer is no longer detectable, it may feel like you are on top of the world.
If you find out it has returned, you may feel like you are falling all over again. To catch recurrence early, it is important to stay on schedule with your surveillance scans and follow-up visits with your medical team.
Report any new or returning symptoms similar to your original diagnosis, avoid smoking, and try to maintain a healthy lifestyle.
If your cancer reoccurs, find a support network. Communicate with your medical team to make educated decisions about your treatment. It can also be helpful to care for your emotional health with things like therapy, meditation, or stress relief techniques.
Remember that recurrences may happen regardless of how well you care for yourself.[4] You may not cure your cancer again, but if you take the right steps, you may live longer with it under control.
Mary Ellen Ellis
WriterMary Ellen Ellis has been the head writer for Mesothelioma.net since 2016. With hundreds of mesothelioma and asbestos articles to her credit, she is one of the most experienced writers on these topics. Her degrees and background in science and education help her explain complicated medical topics for a wider audience. Mary Ellen takes pride in providing her readers with the critical information they need following a diagnosis of an asbestos-related illness.
Anne Courtney, AOCNP, DNP
Medical Reviewer and EditorAnne Courtney has a Doctor of Nursing Practice degree and is an Advanced Oncology Certified Nurse Practitioner. She has years of oncology experience working with patients with malignant mesothelioma, as well as other types of cancer. Dr. Courtney currently works at University of Texas LIVESTRONG Cancer Institutes.
References
- American Cancer Society. (2016, February 12). What is Cancer Recurrence?
Retrieved from: https://www.cancer.org/treatment/survivorship-during-and-after-treatment/understanding-recurrence/what-is-cancer-recurrence.html - De Perrot, M., Feld, R., Cho, B.C.J., Bezjak, A., Anraku, M., Burkes, R., Roberts, H., Tsao, M.S., Leighl, N., Keshavjee, S., and Johnston, M.R. (2009). Trimodality Therapy With Induction Chemotherapy Followed by Extrapleural Pneumonectomy and Adjuvant High-Dose Hemithoracic Radiation for Malignant Pleural Mesothelioma. J. Clin. Oncol. 27(9), 1413-18.
Retrieved from: https://ascopubs.org/doi/full/10.1200/jco.2008.17.5604 - Tandar, A., Abraham, G., Gurka, J., Wendel, M., and Stolbach, L. (2001, September). Recurrent Peritoneal Mesothelioma With Long-Delayed Recurrence. 33(3), 247-50.
Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/11500619 - American Cancer Society. (2016, February 12). Coping with Cancer Recurrence.
Retrieved from: https://www.cancer.org/treatment/survivorship-during-and-after-treatment/understanding-recurrence/coping-with-cancer-recurrence.html