When Lung Cancer Comes Back

Sometimes, lung cancer comes back after you’ve had treatment. This is called a recurrence.

It can happen at any time or not at all. But lung cancer is most likely to return within 5 years after you were diagnosed.

Types of Recurrence

After treatment, some tiny cancer cells may stay in your body. Over time, these cells may divide and grow into a cancer again.

Your lung cancer may come back in your lungs. Or it may return in a different part of your body. There are three types of cancer recurrence:

  • Local: The cancer has come back to your lungs.
  • Regional: The cancer is in the lymph nodes near the lungs.
  • Distant: The cancer is in another part of the body, like the liver, bone, or brain. Even though it’s in a different area, it’s still called a lung cancer recurrence.

Signs of Recurrence

The symptoms of a lung cancer recurrence depend on where it comes back. If it’s in your lungs, you may have:

Other general signs of cancer include:

If you have one or more of these symptoms for a while or they get worse, talk to your doctor. You may also not have any signs of disease at all. That’s why it’s important go to your follow-up appointments. Your doctor will do an exam and may order tests to check for a lung cancer recurrence.

Chances of Recurrence

Your chances depend on what type of lung cancer you have and its stage. The kind of treatment you’ve had may also play a role.

There are two types of lung cancer: Non-small-cell lung cancer (NSCLC) is the most common, accounting for roughly 85% of cases. The other kind is small-cell lung cancer (SCLC).

If you have NSCLC, your chance of a recurrence depends on what stage you have. Your doctor will tell you your stage from 0 to IV. In general, the higher your stage, the more your cancer has spread, and the greater chance it’ll come back. For example, research shows that one in three people with stage I will have a recurrence. For those diagnosed with stage III, the lung cancer will return about 63% of the time.

Continued

SCLC is the most aggressive kind of lung cancer. Although SCLC responds well to treatment at first, most people will have a recurrence in a year or two. When SCLC comes back, it tends to spread faster.

There are two stages:

  • In the limited stage, the cancer is on one side of your chest.
  • If the cancer has spread to both lungs, lymph nodes, or to other parts of your body, that’s called the extensive stage.

Treatment

Your doctors may recommend a different treatment for your cancer recurrence than what you did the first time. They will decide based on:

  • Where it came back
  • Treatments you’ve already gotten
  • Any genetic changes in the cancer
  • Your overall health

Your doctor may prescribe one or more of these treatments. The goal may be to cure the cancer, slow its growth, or ease any symptoms.

  • Chemotherapy: These strong drugs kill cancer cells throughout the body. A lot of the time, chemotherapy doesn’t work as well the second time around. Your doctor may prescribe a different chemotherapy drug or a combination of them.
  • Targeted therapy: These medicines block certain molecules involved in cancer growth, spread, or progress.
  • Immunotherapy: If chemotherapy or targeted therapy doesn’t work, your doctor may try immunotherapy. These drugs help your immune system fight cancer.
  • Radiation therapy: High doses of radiation, such as X-rays, kill cancer cells or keep them from growing. This therapy can treat lung cancer that has spread to the bones or brain. It’s also used to relieve cancer symptoms.
  • Surgery: A surgeon may remove the cancer in your lungs, lymph nodes, adrenal glands, brain, or liver.
  • Endobronchial therapies: In some cases, a tumor can block an airway in your lungs. This can lead to breathing issues, like coughing and pain. You may need a treatment to clear things up. You could have laser therapy, which uses a laser to kill cancer cells. Another option is putting in a stent, a device that helps keep your airways open.

WebMD Medical Reference Reviewed by Jennifer Robinson, MD on September 19, 2019

Sources

SOURCES:

American Cancer Society: “What is Cancer Recurrence?” “Small Cell Lung Cancer Stages,” “Treatment Choices for Non-Small Cell Lung Cancer, by Stage.”

American Lung Association: “Lung Cancer.”

Canadian Cancer Society: “Treatment for Recurrent Non-Small Cell Lung Cancer.”

Japanese Journal of Clinical Oncology: “Relapse of Stage I Small Cell Lung Cancer Ten or More Years After the Start of Treatment.”

Journal of the National Cancer Institute: “Lung Cancer Prognosis Before and After Recurrence in a Population-Based Setting.”

Mayo Clinic: “When Cancer Returns: How to Cope with Cancer Recurrence.”

National Cancer Institute: “Targeted Cancer Therapies,” “Immunotherapy to Treat Cancer.”

National Organization for Rare Disorders: “Small Cell Lung Cancer.”

Therapeutic Advances in Medical Oncology: “Relapsed Small Cell Lung Cancer: Treatment Options and Latest Developments.”

University of California San Francisco Department of Surgery: “Small Cell Lung Cancer.”

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