Lung Cancer Recurrence: 5 Things Doctors Want You to Know

Medically Reviewed By William C. Lloyd III, MD, FACS

Written By Karon Warren on September 8, 2020

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  Expert Insights on Lung Cancer Recurrence

  Treating lung cancer can lead to a period of remission, but remission may not be permanent. Unfortunately, the return of lung cancer—or a lung cancer recurrence—is not predictable and varies from patient to patient based on a variety of factors like age, gender, and smoking status. Finding out their lung cancer has returned can be devastating for patients, but oncologists say it doesn’t mean their lung cancer cannot be successfully treated again. While recurrence will impact their treatment options along with their survival rates, a lung cancer patient could experience remission once more along with a good quality of life.
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  1. “Lung cancer stages indicate how much cancer is in the body.”

  When a patient receives a lung cancer diagnosis, that diagnosis comes with a “stage” label, which indicates how much cancer is in the body. For lung cancer, these range from stage 0 to stage 4 (typically expressed as Roman numerals I, II, III and IV), with the higher the number correlated to how much the cancer has spread. As such, a patient could receive a stage I lung cancer diagnosis, undergo treatment, and experience a short-term period of remission. Later on, though, that same patient could then be upgraded to stage III lung cancer with the return of the cancer.
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  2. “The recurrence does not have to have specific symptoms.”

  Often, when lung cancer reappears after a period of remission, it may not be noticeable or become apparent in the same manner as the original diagnosis. “The recurrence does not have to have specific symptoms similar to what happened at the beginning,” says Dr. Luis Raez, medical director for Memorial Cancer Institute, Memorial Healthcare Systems in Hollywood, Fla. “Many patients with lung cancer diagnoses are already in an advanced or metastatic state because of the lack of symptoms.”
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  3. “There’s no set time for a recurrence.”

  Once a patient undergoes successful lung cancer treatment and enters remission, it’s difficult to say how long that remission may last. That being said, “The risk of recurrence is highest during the first two years after detection and treatment, then recurrence rates slow down but never reach the level of someone who never had lung cancer,” says Dr. Thomas V. Bilfinger, professor of surgery and director of the Lung Cancer Evaluation Center at Stony Brook Medicine in Stony Brook, N.Y.
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  4. “Increased screening is recommended.”

  To monitor for lung cancer recurrence, oncologists encourage lung cancer patients to undergo screening on a more frequent basis. “Increased surveillance is recommended for the first five years,” Dr. Bilfinger says. “Thereafter, screening protocols with low-dose CT scans are what we recommend, although there is no good data out there for long-term surveillance.” The earlier a lung cancer recurrence can be detected, the better the odds of treating that cancer and preventing its spread beyond the lungs.
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  5. “Remission after a lung cancer recurrence is possible.”

  Although a lung cancer recurrence can hinder the patient’s odds of remission, it is possible. “Historically, only 5% of patients with metastatic disease achieve a cure, but that is changing now thanks to new agents,” Dr. Raez says. “For example, with immunotherapy, one out of every six patients now achieve remission for five years and can be considered cured. However, the more recurrences the patient has, the less likely he will be cured.”

Lung Cancer Recurrence: 5 Things Oncologists Want You to Know

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