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When cancer returns after a period of remission, it is called a recurrence. Few mesothelioma patients will confront recurrence, simply because of the aggressive nature of this cancer. It is difficult to fully eliminate mesothelioma tumors in the first place. Because mesothelioma is almost always incurable, recurrence is usually irrelevant.
However, if mesothelioma is diagnosed early, some patients will beat this disease. These few patients must face the possibility that the cancer will return. Cancer survivors are often considered “in remission” rather than “cured.” This is because a recurrence is always a possibility, even years later. For mesothelioma, new treatments are reducing the recurrence rate.
A cancer recurrence means the same cancer has returned after a period of time when it couldn’t be 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 remission. However, you may not be completely cured because the cancer could recur.
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 recur 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.
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 after cancer cells were completely 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 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.
Treatment and Recurrence
Aggressive, mutimodal treatment is the best way to prevent a mesothelioma recurrence. Several treatments can eliminate the 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.
EPP removes nearly all the tissue from one side of the chest cavity, including the lung, pleura, and the diaphragm, which can be artificially reconstructed. Lymph nodes may also be removed during this procedure. Some patients in the study avoided recurrence for longer than patients unable to undergo the procedure with chemotherapy and radiation.
Stories of Survival
Although stories of survival are rare, some people have lived years after a diagnosis of mesothelioma, some with recurrences and others totally cancer free. One patient developed peritoneal mesothelioma, which normally reduces life expectancy to months. This patient survived for 19 years with no recurrences after initial treatment. This is practically unheard of with mesothelioma. There are also stories of patients going six and 12 years after diagnosis and treatment without a recurrence.
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.
Coping 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. Prevention is the best strategy, but no matter what you do, cancer can return. To reduce the odds of a recurrence, follow your doctor’s suggestions, choose healthy lifestyle habits, exercise regularly, and avoiding smoking.
If your cancer recurs, find a support network. 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 you are doing all you can to beat this disease, but recurrences happen. You may not cure your cancer again, but if you take the right steps, you may live longer with it under control.
Page Edited by Patient Advocate Dave Foster
Dave has been a mesothelioma Patient Advocate for over 10 years. He consistently attends all major national and international mesothelioma meetings. In doing so, he is able to stay on top of the latest treatments, clinical trials, and research results. He also personally meets with mesothelioma patients and their families and connects them with the best medical specialists and legal representatives available.