Why does the disease come back? – Firstpost

Filmmaker Tahira Kashyap has revealed that her breast cancer has relapsed, seven years after her initial diagnosis in 2018. In a heartfelt post on Instagram, she wrote, “Seven-year itch or the power of regular screening—it’s a perspective. I’d like to go with the latter and suggest the same for everyone who needs to get regular mammograms. Round 2 for me… I still got this.”

Her post received love from her family, friends and fans, with her husband, actor Ayushmann Khurrana, calling Tahira “my hero”. Tahira disclosed her battle with cancer for a second time on World Health Day, putting a spotlight on the need to get regular health check-ups.

But why do cancers recur? Let’s understand.

What is recurrence in cancer?

Cancer may come back months or years after treatment. This happens when sometimes during treatment, a few cancer cells remain in the body, surviving aggressive therapies.

As per Cleveland Clinic,
cancer may return after remission — when there are no symptoms of cancer and tests show the cancer has disappeared.

This cancer, which occurs after remission, is the same type as the original one. It should not be confused with second cancer which is a new and different cancer.

Speaking to Indian Express, Dr Tripti Raheja, Lead Consultant, Obstetrics & Gynaecology at the CK Birla Hospital, Delhi, explained that some microscopic cancer cells could remain hidden even after successful treatment. Over time, they can grow and cause a recurrence.

Types of cancer recurrence

Recurrent cancer has been classified depending on the location where it crops up.

If the cancer returns to the same place as the original one, it is called local recurrence.

Regional recurrence happens when the tumour develops in the lymph nodes or tissues near the original cancer.

The third is distant recurrence which occurs when the cancer from the original tumour has spread to organs or tissues located far away in the body.

As per the website of City of Hope, a cancer research centre in the US, distant recurrence, also known as metastatic breast cancer, is when the tumour that originally occurred in the breast commonly recurs in bones, liver or lungs.

How common is breast cancer recurrence?

Breast cancer coming back is rare. As per Apollo Hospitals, the rate of breast cancer recurrence in India is estimated to be about 20-30 per cent, depending on the stage of cancer diagnosis, the type of cancer, treatment and individual factors.

According to the American Cancer Society, inflammatory breast cancer (IBC) and triple-negative breast cancer (TNBC) have a higher risk of recurrence than other types of breast cancer.

Women who develop breast cancer before age 35 are more likely to experience the
cancer return.

“The risk of cancer coming back also depends on the type and stage of the original cancer. For example, some cancers, like triple-negative breast cancer, are more aggressive and more likely to return, particularly within the first few years after treatment,” Dr Raheja told Indian Express. 

Local recurrence of breast cancer occurs usually within five years of a lumpectomy, or partial mastectomy. The risk of this cancer is reduced if the surgery is followed by radiation therapy, Cleveland Clinic says.

The website states there is a 3-15 per cent chance of breast cancer recurrence within 10 years after getting this combined treatment.

Symptoms of breast cancer recurrence

The symptoms depend on where the cancer has resurfaced. Those who have local recurrence may experience breast lumps on or under the chest, changes in the nipple, thickening near the surgical scar, swollen skin near the lumpectomy site, and extra firm breast tissue, according to the Cleveland Clinic article.

Regional breast cancer recurrence could cause trouble in swallowing, chronic chest pain, swelling or numbness in one arm or shoulder, and swollen lymph nodes in the armpit or around the collarbone.

Distant breast cancer leads to pain where cancer has developed, chronic dry cough, dizziness, extreme fatigue, lack of appetite, nausea and weight loss, intense headaches, weakness and balance problems or seizures, as per the article.  

How to avoid cancer recurrence

Experts suggest regular follow-up screenings and mammograms for those who have had breast cancer in the past. It is also important to keep an eye on any changes in your breast.

Eating healthy, exercising regularly and sleeping properly are also necessary for cancer survivors.

Experts also advise limiting alcohol intake and staying away from smoking and tobacco products.

“There might also be specific cancer screening guidelines based on a person’s level of risk or if they have a family cancer syndrome. But, in general, the same cancer screening guidelines should be followed as for people who have not had cancer,” says the American Cancer Society.

With inputs from agencies