Lung cancer recurrence: Types, signs, likelihood, and treatment - Medical News Today

Lung cancer recurrence occurs when doctors detect lung cancer after a period of the disease being undetectable. It means that the cancer has come back after treatment that was successful in the short term. The cancer recurrence rate is different for small cell and non-small cell lung cancers, and the chances of recurrence depend on various factors.

Although different treatments can eliminate the cancer cells in someone's lungs, even successful lung cancer treatments cannot guarantee a permanent cure.

This article provides a detailed look at the science of lung cancer recurrence, including the types, signs, likelihood, causes, and risk factors. It also discusses the treatment for lung cancer and the support options and outlook for people living with the disease.

The American Cancer Society (ACS) defines recurrent cancer as cancer that doctors find after treatment and after a period during which there were no detectable signs of cancer.

There are three main types of cancer recurrence:

• Local recurrence: The cancer comes back in the same area in which the initial cancer started.
• Regional recurrence: The cancer comes back in the lymph nodes that surround the area in which the initial cancer started.
• Distant recurrence: Cancer appears in a part of the body that is some distance from the area in which the initial cancer started.

Distant recurrent cancers are different than second cancers, which the ACS defines as cancers that develop after the initial cancer but are unrelated to it.

People with lung cancer have an increased risk of developing the following second cancers:

The signs of cancer recurrence will depend on where the cancer has recurred. If the cancer recurs in the lungs, for instance, then the typical signs of recurrent lung cancer will be the same as the common signs of initial lung cancer.

The ACS lists these symptoms as follows:

However, if the recurrent cancer arises in a different body part, it could cause other symptoms. Examples include:

• bone pain, if the cancer is in the bones
• headaches, balance problems, dizziness, and seizures if the cancer is in the brain
• jaundice, if the cancer appears in the liver
• swollen lymph nodes, if the cancer appears in the lymph nodes

The data on the rates of lung cancer recurrence are limited, and there is a need for further large scale research.

However, research from 2020 suggests that about 30% of people with lung cancers in stages 1 to 3 will develop recurrent cancer.

The authors state that the most common form of recurrent lung cancer is a distant cancer of the central nervous system. Such cancers make up around 37% of all recurrent lung cancers.

However, the chance of recurrence can depend on the type of lung cancer:

Non-small cell lung cancer (NSCLC)

For people with NSCLC, some evidence points toward the following chances of recurrence:

• 5–19% for stage 1
• 11–27% for stage 2
• 24–40% for stage 3

Small cell lung cancer (SCLC)

It is more difficult to find precise estimates of recurrence rates for SCLC.

However, researchers suggest that the vast majority of people with this form of lung cancer will experience a recurrence.

According to Cancer Research UK, cancer may return because the initial treatment did not remove all of the cancer cells, and the leftover cells developed into a new tumor.

In other cases, the cancer cells may have spread to other areas of the body, forming a tumor elsewhere.

Can a person prevent lung cancer from returning?

As the ACS explains, it may be possible for some people to lower their chances of cancer recurrence. They can minimize the risk by:

• quitting smoking, if applicable, or avoiding secondhand smoke
• exercising
• eating a well-balanced, nutritious diet

Even if the cancer has spread, quitting smoking may help those with lung cancer live longer. It can also reduce the chance of another lung cancer developing.

More research is necessary to understand the extent to which diet and exercise can influence lung cancer recurrence.

The ACS explains that treatment options will vary for recurrent lung cancers.

The appropriateness of any given treatment option will depend on:

• when the cancer recurred
• where it recurred
• how much it has spread
• a person's overall health
• a person's values and wishes

Recurrent lung cancer treatments could include:

Learn more

Learn more about treatment for lung cancer.

The outlook for people with recurrent lung cancer will vary greatly. Various factors, including the type and severity of lung cancer and the presence of other conditions, can determine a person's outlook.

Recurrent lung cancers can also cause serious mental health conditions, such as anxiety and depression. It can be very challenging for someone to survive one lung cancer, only to see it come back. Adequate mental health care is, therefore, often very important.

A person who needs extra support can contact the following organizations:

Anyone who experiences symptoms of lung cancer should promptly seek the advice of a doctor.

Earlier detection of cancer increases a person's chances of recovery because treatment is more likely to be effective.

Below, we answer some frequently asked questions about lung cancer recurrence.

Does lung cancer always come back?

Lung cancers do not always recur.

However, a significant proportion of NSCLCs can recur, alongside the majority of SCLCs.

How long does lung cancer stay in remission?

The duration of remission depends on many factors, and the data are complex.

For instance, research shows that lung cancer recurrence after successful surgery for NSCLC typically occurs at 6–8 months or 22–24 months.

In contrast, in people with SCLC, the average remission period after second-line treatment is about 4.6 months.

No lung cancer treatment is wholly reliable. Even if doctors manage to treat someone's lung cancer temporarily, there is a chance of the cancer recurring.

If a person notices any symptoms of lung cancer recurrence, they should contact a healthcare professional immediately.