Recurrence of mesothelioma tumors is unfortunately not an issue that many patients have to confront. Normally that would be positive to not have to deal with recurrence, but with mesothelioma so few patients are ever able to fully eliminate tumors and cancer cells from the body. For many reasons mesothelioma is mostly considered an incurable type of cancer, making recurrence irrelevant.
Although it isn’t common, some people do beat mesothelioma. If it can be diagnosed in earlier stages and other factors fall into line, a person can survive this cancer. It is these few patients who then have to face the possibility that the cancer will return. Cancer survivors are often referred to as being in remission, because a recurrence is always a possibility, even years later. For mesothelioma, new treatments are reducing the recurrence rate.
In mesothelioma, as in any other type of cancer, a recurrence means that the cancer reappears after a period of time during which it could not be detected. If you have mesothelioma in an early stage, receive aggressive treatment and your doctors can no longer find the cancer in your body, you may be considered cured. However, if the cancer is detected again in the future, it is a recurrence.
A recurrence does not have to appear in the same part of the body in which the cancer first began. If you have recovered from pleural mesothelioma, for instance, a recurrence may come in the form of cancer in the abdominal cavity. Your cancer would still be referred to as pleural, but recurrent. Cancer recurrence may be local, meaning it came back to the same part of the body, regional, if it returns to lymph nodes close to where it originated, or distant, if the cancer returns to a completely different part of the body.
Progression vs. Recurrence
Progression is another term used in cancer care, which may be confused with recurrence. A return of cancer can only be called a recurrence if there was a period of time in which all tumors and cancer cells were eliminated from the body. Progression describes cancer that has not been fully cured and begins to progress, or get worse.
This can be confusing in mesothelioma because complete remission from this type of cancer is so rare. Treatment may result in a partial remission, meaning that half or more of a tumor has been eliminated. If you experience this you may feel much better and feel as if you are healing. Your cancer has not been eliminated, though, so if it gets worse again it has progressed, not recurred.
Treatment and Recurrence
So far the best way to limit recurrence in patients with mesothelioma is with aggressive, multimodal treatment. This means using multiple treatment strategies to eliminate the cancer, usually involving surgery, chemotherapy, and radiation. One study of patients with mesothelioma found good survival rates for many of the patients that had the most aggressive type of surgery: extrapleural pneumonectomy, or EPP.
EPP is a surgery that involves removing nearly all the tissue from one side of the chest cavity, including the lung, pleura, and even the diaphragm, which can be artificially reconstructed. It may also include the removal of lymph nodes. Some patients in the study were able to avoid recurrence of the disease for longer than patients who were not able to undergo the procedure, as well as chemotherapy and radiation.
Stories of Survival
These stories are rare, but some people have lived years after a diagnosis of mesothelioma, some with recurrences that they fought, others totally cancer free. One such story was described in a study. The patient developed peritoneal mesothelioma, which normally comes with a life expectancy that is measured in months. This patient survived for 19 years, and had no recurrences after the initial treatment, practically unheard of with mesothelioma. This is rare, but there have also been stories of patients going six and 12 years after diagnosis and treatment without a recurrence.
As treatments for this very difficult type of cancer evolve, it has become clear that the need to deal with recurrences is actually an improvement. Recurrence in mesothelioma is becoming more of an issue because earlier diagnoses and better treatments are helping more people beat this disease. As with many types of cancer, once it can be cured, recurrence is a common factor in long-term survival.
Many specialists in mesothelioma now talk about controlling the disease, rather than curing it. There is no real cure. A few people seem to get lucky, but researchers don’t know why. What is more important is that newer treatments are allowing doctors to control mesothelioma in their patients. They can help their patients live longer with the disease, and that is a major improvement.
Coping with a Recurrence
As recurrences become more common in mesothelioma, patients must now learn how to cope with them. It may be the best feeling in the world to find that your cancer is no longer detectable and then the worst to find out that it has returned. Prevention is a good first step, but no matter what steps you take a recurrence may still occur. Measures that can help improve the odds of preventing a recurrence include following your doctor’s suggestions and maintaining healthy lifestyle habits, like a good diet, regular exercise, and avoiding smoking.
If you do have a recurrence make sure you have the loved ones that make up your support network around you. Reach out for help and communicate with your medical team to make sure that you do everything you need to do to keep fighting mesothelioma. It also helps to cope with negative emotions in healthy ways like through therapy, meditation, stress relief, and other ways that make you feel better. Remember that you are fighting and doing all you can to beat this disease, but that recurrences happen. You may not cure your cancer again, but if you take the right steps you may be able to live longer with it under control.
Page edited by Dave Foster
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