How Do You Know If Lung Cancer Has Come Back?

5 min read


How Do You Know If Lung Cancer Has Come Back?

When lung cancer goes into remission, it’s certainly a cause for celebration! For some people, remission marks the end of treatment for lung cancer. However, even with advancements in treatment, lung cancer may begin to grow again after a period of remission. 

It’s really important for lung cancer survivors to schedule follow-up oncology appointments and know the signs of lung cancer recurrence. Below, we’re sharing more about tests run to determine if it’s returned, possible treatment options, and risk factors that you may be able to control.

What is Lung Cancer Recurrence?

Once a patient enters remission, they may believe that there is no more potential for lung cancer to return. However, remission is not the same thing as a cancer cure. Remission means that the signs and symptoms of the cancer have been reduced. Lung cancer recurrence happens when your cancer returns after you’ve been in remission for at least one year. 

Your chances of lung cancer recurrence depend on which type you have and the stage of the lung cancer. The two main types of lung cancer are non-small-cell lung cancer (NSCLC) and small-cell lung cancer (SCLC). 

Unfortunately, it is pretty likely for both types of lung cancer to return after treatment. NSCLC was found to have a 30-75% chance of recurrence in one study. SCLC is even more aggressive and holds an even higher chance of recurrence. Most people who undergo treatment for SCLC experience recurrence within a year or two of remission.

Lung cancer recurrence is most common within five years of diagnosis. 

Types of Lung Cancer Recurrence

There are three main ways that lung cancer recurs, depending on where the cancer returns. 

  1. Local recurrence is when cancer returns to the lung close to where it was initially found.
  2. Regional recurrence happens when cancer grows in the lymph nodes near the initial site. 
  3. Distant recurrence occurs when the lung cancer is found in a new site far from where it was initially located, such as in the brain, bones, adrenal glands, or liver. 

If lung cancer returns after at least one year of remission, your oncologist will tell you that you have recurring lung cancer. Recurring lung cancer is relatively common, and tests will be conducted to determine if the same type of cancer has returned or if you have secondary cancer

In some cases, specific treatments can cause a secondary cancer to develop after the cancer has gone into remission. This is not the same as a recurrence and is referred to as a second cancer. If your doctor performs a biopsy and finds that the cancer cells look different, it is not a recurrence but a second type of cancer. 

Signs of Lung Cancer Recurrence

Your doctor may find that your cancer has returned through a routine scan, or you may experience signs and symptoms that warrant further investigation. Similar to the symptoms of lung cancer, here are some common signs of recurring lung cancer if it develops locally: 

  • Persistent cough
  • Coughing up blood
  • Wheezing, difficulty breathing, shortness of breath
  • Dizziness and visual disturbances
  • Weight loss
  • Chronic fatigue

The signs of returning lung cancer can vary for each person, but most depend on where the cancer is growing in the body. In addition to the symptoms listed above, if cancer has spread to a distant location, such as the bones, brain, or liver, the following signs can also occur: 

  • Pneumonia
  • Deep pain in the chest, back, arms, legs, or shoulders
  • Weakness on one side of the body
  • Poor coordination
  • Abdominal pain
  • Jaundice or yellowing of the skin and eyes
  • Itchiness
  • Confusion

Some of these issues are related to where the cancer returns. Sometimes confusion and coordination can be related to signs that lung cancer has spread to the brain, while jaundice could mean it’s spread to the liver. Any of the potential symptoms listed above are enough to see a doctor about, even if they end up being unrelated to cancer!

What Causes Lung Cancer Recurrence?

Even when lung cancer has gone into remission, it is still possible for cancer cells to linger that are not detectable on a scan. These cells can either grow into a localized tumor or get into the bloodstream and spread to a new part of the body. Some people have different genetic or lifestyle factors that can increase the risk of recurrence. 

Lung Cancer Risk Factors

Some risk factors make developing lung cancer more likely for individuals. Risk factors can include:

  • Smoking
  • Secondhand smoke
  • Exposure to radon or asbestos
  • Arsenic in your drinking water 
  • Previous radiation therapy to lungs
  • Air pollution
  • Family history of lung cancer

The leading factor is a person’s current smoking status, as smoking alone significantly increases the chances of recurrence. Modifying certain risk factors, like quitting smoking or exposure to secondhand smoke, can lower your chances of having a recurrence of lung cancer.

How Do Doctors Treat Lung Cancer Recurrence?

If your lung cancer returns, your oncologist may recommend one or more of the following treatments based on your situation to help increase survival time and improve quality of life. 

Treatments for lung cancer recurrence can include: 

  • Chemotherapy is one of the most common approaches to treating lung cancer recurrence. Chemotherapy uses cytotoxic drugs to kill cancer cells. Your oncologist may use the same types of chemotherapy drugs initially used, or they may recommend a new type depending on how you responded the first time. 
  • Targeted therapies may be available to those with recurrent non-small cell lung cancer. This treatment approach uses special medications that target and kill cancer cells based on a genetic mutation that can be identified while causing less harmful effects to the surrounding cells.

Different targeted therapies are available for different gene mutations. These mutations aren’t genetic but instead caused by exposure to chemicals in smoke or environmental exposures. Cancer cell growth can be stopped or slowed by using the right targeted therapy for the mutation. If your lung cancer doctor suggests biomarker testing (genomic testing), they are likely looking to see if a drug is available to target your specific genetic mutation. 

  • Radiation therapy may be used to shrink tumors that have developed in other areas of the body. 
  • Surgery, while not a typical approach to the recurrence of lung cancer, can sometimes be used to remove a localized tumor in the lung or in another area of the body.

Finding an effective treatment for lung cancer that has returned is often difficult. Recurring lung cancer has usually advanced and spread to new parts of the body. For this reason, treatment usually focuses on increasing comfort for the patient. 

Recurrent Lung Cancer Treatment in Portland-Vancouver

If you have been diagnosed with recurrent lung cancer, Compass Oncology oncologists offer patients comprehensive cancer care and the latest treatments for lung cancer based on their unique situation. Our cancer centers are in Portland, Tigard, OR, and Vancouver, WA. Our lung cancer doctors help each patient with a personalized treatment plan to help you get the most out of your cancer treatment.

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