Cancer relapse decoded: Causes, types, reasons for recurrence and prevention strategies

Causes of cancer relapse: Sometimes, incomplete treatment or weak immunity tilts the balance further in favour of relapse (Image: Pexels)

Cancer relapse can be a major setback for patients and families who once believed that the battle was won, only to face emotional turmoil once again. While there have been several advances in modern oncology, the chances of cancer returning after treatment remain a harsh reality.

Cancer recurrence refers to the return of the disease after treatment is completed and that the tumour was undetectable for a period of time. In spite of all medical and technological advances, recurrence remains a major fear in the mind of both patients and oncologists.

Says Dr Pushpinder Gulia, Director, Surgical Oncology & Robotic Surgery, CK Birla Hospital, Gurugram, “The reasons are layered. Some cancers are diagnosed late, others have aggressive biology, while a few survive as microscopic cells hidden in the body. Sometimes, incomplete treatment or weak immunity tilts the balance further in favour of relapse.”

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Dr Gulia explains the types  of recurrence, reasons why cancers return, and preventive tips:

Types of cancers:

• Local recurrence: Cancer returns at the original site
• Regional recurrence: Cancer appears in nearby tissues or lymph nodes
• Distant recurrence: Metastasis occurs in other organs of the body.

• Advanced stage at diagnosis: Detected it late, it has a higher chance of returning.

• Aggressive tumour biology: High grade cancers are ones with genetic mutations like p53, resist treatment.

• Microscopic residual disease: In this type of cancer, some tiny circulating cancer cells survive despite surgery, chemo therapy, or radiation.

• Dormant cancer cells: Some remain in a sleep phase, thus evading therapy.

• Incomplete or irregular treatment: Breaks, delay, or incorrect therapy, weaken long-term success.

• Immune evasion: in conditions like HIV, TB, or post-transplant, lowered immunity may raise recurrence risk.

How to prevent cancer relapse

• Adjuvant and neoadjuvant therapies: Chemotherapy, radiation, or targeted drugs before or after surgery to shrink tumours and wipe out hidden cells.

• Targeted therapies and immunotherapy: Medicines designed to attack specific mutations, or boost the immune system to destroy cancer cells.

• Maintenance therapy: In selected cases, low-dose medication helps keep dormant cells from “waking up.”

• Lifestyle modification: “Simple choices like quitting smoking, exercising, maintaining a healthy diet, reduce the risk of recurrence significantly,” emphasises Dr Gulia.

• Surveillance and follow-up: Structured scans, blood tests, and check-ups ensure early detection if cancer does return.

• Precision medicine: Genomic profiling allows personalised treatment, giving doctors foresight on recurrence risks.