Recurrence of mesothelioma tumors is not something many patients confront, simply because of the aggressive nature of this cancer. Few mesothelioma patients ever fully eliminate tumors and cancer cells in the first place. Mesothelioma is almost always incurable, making recurrence irrelevant.
A few people do beat mesothelioma, if it is diagnosed early and they are lucky. These few patients 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.
Recurrence means the cancer reappears after a period when it could not be detected. If you have early stage mesothelioma, receive aggressive treatment and your doctors can no longer find the cancer in your body, you may be considered cured. However, the cancer could recur someday.
A recurrence does not have to appear in the same part of the body where the cancer began. If you have recovered from pleural mesothelioma, for instance, cancer could recur 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 cancer care term which may be confused with recurrence. A return of cancer can only be called a recurrence if there was a time when all tumors and cancer cells were eliminated from the body. Progression describes cancer that has not been fully cured and gets worse.
Complete remission from mesothelioma is so rare that this can be confusing. Treatment may result in a partial remission, meaning that half or more of a tumor has been eliminated. You may feel much better and feel you are healing. Your cancer has not been eliminated, though, so if it gets worse again it has progressed, not recurred.
Treatment and Recurrence
Aggressive, mutimodal treatment is the best way to limit recurrence of mesothelioma. Several treatments are used to eliminate the cancer, usually surgery, chemotherapy, and radiation. One study of mesothelioma patients found good survival rates for many who had the most aggressive (and dangerous) surgery: extrapleural pneumonectomy, or EPP.
EPP removes nearly all the tissue from one side of the chest cavity, including the lung, pleura, and even the diaphragm, which can be artificially reconstructed. Lymph nodes may also be removed. Some patients in the study avoided recurrence of the disease for longer than patients who were not able to undergo the procedure with 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 patient developed peritoneal mesothelioma, which normally reduces life expectancy to months. This patient survived for 19 years, and had no recurrences after the initial treatment, something 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 difficult cancer improve, though, more patients will face recurrence. As with many types of cancer, once it can be cured, recurrence is a common factor in long-term survival.
Mesothelioma specialists 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. Newer treatments are allowing doctors to control mesothelioma in their patients. They can help their patients live longer with the disease, a major improvement.
Coping with a Recurrence
As recurrences become more common in mesothelioma, patients must cope with them. It may be the best feeling in the world when your cancer is no longer detectable, then the worst to find out it has returned. Prevention is a good first step, but no matter what you do, cancer can come back. Measures that decrease the odds of a recurrence include following your doctor’s suggestions and healthy lifestyle habits, like a good diet, regular exercise, and avoiding smoking.
If your cancer recurs make sure you have a support network of loved ones around you. Reach out for help and communicate with your medical team to make sure you can keep fighting.Cope with negative emotions in healthy ways like therapy, meditation and stress relief techniques. 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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