Cancer Recurrence
When cancer patients are given the “all clear” by their oncologist, they breathe an understandable sigh of relief.
Many of them, however, enjoy short-term remission only, followed by a deadly recurrence.
Recurrence rates at a glance:
Breast cancer 20% – 40%
Prostate cancer 20% – 60%
Lung Cancer 20%
Colorectal cancer 15% – 30%
Stomach cancer 54%
Kidney cancer 46% – 56%
Skin cancer 24% – 45%
Pancreatic cancer 72%
Ovarian cancer 70% – 85%
…more details below.
What is Cancer Recurrence?
Cancer that has recurred (come back), usually after a period of time during which the cancer could not be detected. The cancer may come back to the same place as the original (primary) tumor or to another place in the body. Source: National Cancer Institute
Types of Recurrent Cancer
Local recurrence – the cancer is in the same place as the original cancer or very close to it.
Regional recurrence – the tumor has grown into lymph nodes or tissues near the original cancer.
Distant recurrence – the cancer has spread to organs or tissues far from the original cancer. When cancer spreads to a distant place in the body, it is called metastasis or metastatic cancer. When cancer spreads, it is still the same type of cancer. For example, if you had colon cancer, it may come back in your liver. But, the cancer is still called colon cancer. Source: National Cancer Institute.
Why does cancer recur?
- standard treatment does not eliminate cancer stem cells. These often go on to grow new, more aggressive tumors that are treatment resistant.
- the original treatment didn’t get rid of all the cancer cells and those left behind form a new tumour.
- standard treatment does not address the underlying cause of the cancer.
- standard treatments themselves often cause new cancers to develop.
- patients are not properly advised about the importance of diet and lifestyle changes necessary to prevent a recurrence.
Other factors that contribute to recurrence
Several studies have shown that the following are associated with an increased incidence of recurrences, according to this Review.
- western dietary pattern
- obesity
- weight gain
- a sedentary lifestyle
- high serum levels of insulin
- growth factors
- inflammatory cytokines
- metabolic syndrome (high blood pressure, high blood sugar, too much fat around the waist, and high cholesterol or triglyceride levels etc)
The Role of Cancer Stem Cells in Cancer Recurrence and Metastasis
Because of their relatively slow rate of proliferation, cancer stem cells (CSCs) may be resistant to chemotherapeutic strategies that target rapidly dividing cancer cells. Moreover, the tumor microenvironment and dysregulated stemness pathways may provide additional protection against chemotherapy and radiation.
Although chemotherapy and radiation may kill most of the cells in the tumor, CSCs that are not eradicated may lead to regrowth or recurrence of the tumor either at the primary site or at distant sites. Source: Boston Biomedical
Recurrence rates – a closer look
Breast cancer
Almost 30% of patients with breast cancer who are free of disease after initial local and regional treatments present with disease recurrence during follow-up, says this 2015 study
This 2019 study says 20–40% of all breast cancer patients develop recurrence
Cancer subtypes: More aggressive breast cancer subtypes have higher recurrence rates. Research suggests that about 40% of people diagnosed with early-stage triple-negative breast cancer are likely to have a recurrence and up to 50% of people diagnosed with inflammatory breast cancer are likely to have a recurrence. These two subtypes are more likely to recur than other subtypes of breast cancer. Source
Prostate cancer
20-40% recurrence rate after radical prostatectomy – 2018 study
10–30% at 5 yr recurrence after radiotherapy and/or brachytherapy – 2022 study
50–60% at 10 yr recurrence after radiotherapy and/or brachytherapy – 2022 study
Non-Small-Cell Lung Cancer
20% – 5-year cumulative incidence of recurrence was
9.3% experienced recurrence thereafter.
Nearly 82% of recurrences were at distant sites and associated with poor survival. – 2023 Study
Kidney Cancer (Renal Cell Carcinoma)
46.4% 3-year recurrence rates are for clear-cell RCC
56.1% for non–clear-cell/other types
– 2024 study
Melanoma (Skin)
24% to 45%, with a median time to recurrence around 14 months – 2023 study
Pancreatic cancer
72.2% recurrence (most had surgery followed by chemotherapy) – 2024 study
Ovarian cancer
70% to 80% of patients that reach a remission will still have recurrent disease. although they respond well to frontline chemotherapy Unfortunately, a significant proportion will have disease recurrence in less than 6 months – 2021 article
85% of patients with Epithelial Ovarian cancer who achieve a full remission following first-line therapy will develop recurrent disease – 2017 study.
Colorectal cancer
15% and 30% of patients with stage II or III colorectal cancer developed recurrence after curative surgery, – 2021 study
Stomach Cancer
(after curative surgery) – 2020 study
6.6% Peritoneal recurrence
19.4% regional recurrence
7.2% local recurrence
21.1% distant recurrence
Soft tissue sarcomas
50% of patients after adjuvant chemotherapy – 2025 study.
Top recommendations for the prevention of a recurrence.
Be physically active as part of everyday life
This systematic review of 100 studies involving 68,000 cancer patients found that superior levels of exercise following a cancer diagnosis were associated with a 28%–44% reduced risk of cancer-specific mortality,21%–35% lower risk of cancer recurrence, 25%–48% decreased risk of all-cause mortality.
A large cohort study of 2987 female registered nurses in the Nurses’ Health Study who were diagnosed with stage I, II, or III breast cancer found that women who exercised moderately (the equivalent of walking 3 to 5 hours per week at an average pace) after a breast cancer diagnosis had approximately 40% to 50% lower risks of breast cancer recurrence, death from breast cancer, and death from any cause compared with more sedentary women. Read more at Start daily physical exercise
Follow a healthy diet rich in wholegrains, fruits, vegetables and beans.
Cancer Stem Cells are the only cells that can give rise to new tumors. Standard treatment does not eliminate them. This is why cancers usually recur (come back). However, Dr Young S. Kim, a scientist at the National Cancer Institute in the US showed that poor diet causes cancer stem cells to regrow while a good diet could stop that regrowth.
This American Cancer Society study found that Colorectal cancer patients who improve their diet and lifestyle survive longer with a 42% reduced risk of death than those who do not make the changes.
A study by Vanderbilt-Ingram Cancer Center and Shanghai Center for Disease Control and Prevention of 4,886 Chinese breast cancer survivors diagnosed with stage 1 to stage 4 breast cancer found cruciferous vegetable intake during the first 36 months after breast cancer diagnosis reduced recurrence by 21% to 35%. Read more at Radically change your diet
Maintain a healthy weight
Weight gain during or after breast cancer treatment increases the risk of recurrence and reduces survival, irrespective of baseline body mass index.
This Systematic Review of 17 Reviews says breast cancer survivors who are overweight (body mass index (BMI) 25–29.9) or obese (BMI >30) have poorer outcomes than those with a normal BMI, with higher recurrence rates, poorer responses to treatment and increased secondary cancer rates. A recent meta-analysis concluded that women living with obesity have a one-third increased risk of breast cancer mortality and a 41% increased risk of overall mortality compared with women with breast cancer who have a normal weight.
Practice Overnight Fasting (13 hours+)
This study of 2413 women with breast cancer found that fasting less than 13 hours per night was associated with a 36% increased risk of breast cancer recurrence compared with nightly fasting more than 13 hours or more.
Do not smoke
Compared with women who continue to smoke after a breast cancer diagnosis, those who quit smoking after diagnosis have higher overall survival and possibly better breast cancer–specific survival.
This 2019 study, published in the New England Journal of Medicine says: Evidence shows that continued smoking after a cancer diagnosis is associated with increased adverse outcomes from cancer treatment, increased mortality post treatment, increased risk of a new primary cancer, and an increased risk of cancer recurrence. Conversely, quitting smoking after a cancer diagnosis can reduce virtually all of these negative outcomes, producing longer survival and a reduced risk of new cancers.
This 2022 Systematic Review, published in the Journal of Breast Cancer says: Numerous studies conducted in patients with lung, head, and neck cancer have shown that cigarette smoking is associated with recurrence after a primary diagnosis. Given the current evidence, although limited, active smokers should quit smoking after Breast Cancer (BC) diagnosis as trends indicate a positive association between active smoking and BC recurrence.
Limit Alcohol Consumption
This 2023 study of 15 199 adults with a cancer diagnosis found: Alcohol consumption and risky drinking behaviors among cancer survivors are associated with various adverse long-term outcomes, including higher risk of recurrence, secondary primary tumors, and increased mortality. In a meta-analysis involving 209 597 cancer survivors, alcohol consumption was associated with a 17% increased risk of cancer recurrence and an 8% increased risk of overall mortality.
This Systematic Review and Meta Analysis of 117 studies enrolling 209 597 cancer survivors says alcohol intake was associated with increased risk of breast cancer recurrence
Higher intakes of alcohol were associated with increased mortality rates among survivors of hepatocellular carcinoma non-Hodgkin lymphoma, laryngeal and pharyngeal cancer, and head and neck cancer.
Add Nutritional Supports for relapse prevention
According to this 2019 Systematic Literature Review of 20 research studies and 12 articles on bioactive plant extracts there are several phytochemical bioactive foodstuffs with proven modulating effects of tumor growth, progression, and metastasis, and therefore may be successful in treating or preventing a cancer relapse. Here they are:
Breast cancer
Green Tea (Epigallocatechin gallate )
Quercetin
Flaxseed (Secoisolariciresinol diglucoside)
Sweet potatoes (β-Sitosterol-d-glucoside)
Chokeberries (Aronia)
Castor oil
Thunder god vine
Prostate cancer
Apigenin
Curcumin
Naringenin
Grape seed extract (Procyanidin B2-3,3-di-O-gallate)
Quercetin
Andrographis paniculata (Supplement)
Sorghum (an ancient grain – available as a supplement)
Lung cancer
Apigenin
Curcumin
Green Tea (Epigallocatechin gallate)
Leukaemia
Ginger
Colorectal cancer
Curcumin
Omega-3 fatty acid -found in tuna and salmon. (Docosahexaenoic acid)
Green Tea (Epigallocatechin gallate)
Ginseng
Grape seed
Orange peel
Rosemary and shark liver oil
Watercress and broccoli
Sources:
World Cancer Research Fund
Review
Take further precautions with these Cancer Prevention tips.
“If you don’t ‘Stop Making Cancer’, it doesn’t matter how good anyone is at getting rid of it, it will come back.”
Dr. Thomas Lodi, MD, MD(H), IMD, DHS
Worried about a recurrence?
Source: American Cancer Society
It’s easy to worry over every ache and pain if you’ve had cancer. There are only a few symptoms that could mean serious problems. If you have any of the problems listed below, tell your cancer care team.
- Return of the cancer symptoms you had before (for example, a lump or new growth where your cancer first started)
- New or unusual pain that’s unrelated to an injury and doesn’t go away
- Weight loss without trying
- Easy bleeding or unexplained bruising
- A rash or allergic reaction, such as swelling, severe itching, or wheezing
- Chills or fevers
- Frequent headaches
- Shortness of breath
- Bloody stools or blood in your urine
- New lumps, bumps, or swelling with no known cause
- Nausea, vomiting, loss of appetite, or trouble swallowing
- Diarrhea,
- A cough that doesn’t go away
- Any other signs your cancer care team has talked to you about or any unusual symptoms that you just can’t explain.
To stay cancer-free please see these 32 Cancer Prevention tips.
Getting tested
Risk of Recurrence Tests available from private labs to detect cancer early.
Recommended reading:
CANCER FREE! Are You SURE?
By Jenny Hrbacek
Source: cancerfreeareyousure.com
I spent 4 years and some $40,000 learning what my oncology team did not tell me. And I share it all with you. This book gives you a clear roadmap – what the tests are, what they look for, how to order them, the degree of accuracy, what they cost, and more. I also give you the big picture as to what causes cancer so you are empowered to prevent it. And if you are in treatment, I tell you how you can avoid the toxic one-size-fits-all standard of care that opens the door for far too many of us to have a recurrence of cancer. Did you know that 90% of people who get a recurrence die within 5 years? Don’t let that be you. Find cancer early – get tested.
Note: cancerireland.ie has no financial or other involvement with any of the products or services listed on this site.
Cancer Recurrence
Q1. What is cancer recurrence?
Cancer recurrence means the cancer has returned after treatment and after a period where no cancer was detectable.
Q2. When is cancer most likely to come back?
Most recurrences happen within the first 2–5 years after treatment, though this varies by cancer type.
Q3. Can cancer come back after 10 years?
Yes. While recurrence risk is highest in the first few years, some cancers—such as hormone receptor–positive breast cancer—can recur even after 10 years.
Q4. Which cancers have the highest recurrence rates?
Cancers with higher recurrence rates include small cell lung cancer, advanced colorectal cancer, and triple-negative breast cancer.
Q5. How do doctors detect cancer recurrence?
Doctors use follow-up appointments, blood tests (like PSA for prostate cancer), imaging scans, and sometimes biopsies to check for recurrence.
Q6. What should I do if I’m worried about recurrence?
Talk to your doctor about your individual risk, attend all follow-ups, and consider support groups or counselling to help with anxiety.
Page created September 2025