Difference between Recurrence and Spread?

CherylHutch
CherylHutch Member Posts: 1,375
edited March 2014 in Colorectal Cancer #1
I know there must be a difference... or is there really?

If you have a recurrence of colon cancer, what is the difference between it recurring or spreading? If your colon cancer spreads to your lungs or liver, it is considered to have metasticized and I've heard people talk about the "mets" in their lung or liver.

Is there a difference between having mets somewhere outside the colon/intestine and having a recurrence?

Inquiring minds want to know.

Huggggs,

Cheryl

Comments

  • PGLGreg
    PGLGreg Member Posts: 731
    same thing
    I don't think there's a real difference, except that when you call it a recurrence, you imply that there was a time after the first occurrence when there was no apparent cancer, before the cancer again became apparent.
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  • apache4
    apache4 Member Posts: 272 Member
    This might be an answer
    In my understanding, apread would just be a simpler word to use then matastisize. If the original tumor is in the colon and then spread from that point, you have mets to the, let's say, liver. That makes you a Stage IV.
    If the tumor is found in the colon and completely removed, with no tumors anywhere else, I would say that new tumors found in the liver would be a recurrance of the colon cancer since it was removed from the colon but has recurred in the liver ( or lungs).
    This question of a period of time NED had puzzled me. My onc said that my brief NED experience only showed that the PET scan could not see any cancer at that time. He says that with Stage IV it is always there only too microscopic to see. My original onc in Texas said the same thing. The cancer cells in the blood are always there and the chemo keeps them under control. He said that they also mutate to keep themselves alive and that is why one therapy does not work forever. (I wish they understood that when they kill their "host" they also kill themselves :)). So, when mine came back big enough to see again, I felt that it was not a recurrance, but just them getting crazy and able to grow again with no chemo to fight them. Since we still don't know what the real cause of this is, I continue to hope that it might just slow down on it's own.
  • HDLadyRider
    HDLadyRider Member Posts: 10
    I've Wondered the Same Thing
    Interesting post for me. My husband had four tumors resected from the liver in March. When the PET scan was done in June, there was a new tumor. I asked the liver surgeon if this was a reccurence and he basically told me no, it was simply to tiny during resection to notice on the ultrasound done during surgery and that it just considered a new tumor, but not recurrence. I don't understand exactly what is considered recurrence and just continuing cancer.
  • CherylHutch
    CherylHutch Member Posts: 1,375

    I've Wondered the Same Thing
    Interesting post for me. My husband had four tumors resected from the liver in March. When the PET scan was done in June, there was a new tumor. I asked the liver surgeon if this was a reccurence and he basically told me no, it was simply to tiny during resection to notice on the ultrasound done during surgery and that it just considered a new tumor, but not recurrence. I don't understand exactly what is considered recurrence and just continuing cancer.

    Thanks, everyone... I'm finding this whole discussion very interesting and each of the explanations is helping me understand this cancer jargon a bit more. For some reason, I had assumed that "recurrence" was something that this particular cancer (colon) had a high risk of. But that once it started spreading, then that made it different and more dangerous, so to speak.

    But it does make sense that it's all really an ongoing progression of the same thing. If you are diagnosed with a primary cancer, then my understanding is you are not "cured" until you can go NED for 5 years without a recurrence/spread. So each time they find something, then it's a matter of dealing with that which they've found and treating it.

    So am I correct in thinking that as long as they are treating your current growths/tumours, be it with chemo/drugs, radiation or surgery, it doesn't really matter if it has metasticized or is called a recurrence, treating it is a continuation of trying to get rid of the nasty monster.

    My lung surgeon gave me an analogy that made sense as to why a surgeon might not recommend surgery. In the case of the lungs, if you only have one growth, then it might be beneficial to go in and take that growth out. If you have one known growth and a couple of small ones that are just big enough to be seen on a CAT or PET scan, then this might be the sign of more to come. He said it's like throwing a handful of dandilion seeds on the ground. If you see one dandilion, you can pluck it out by the roots and have no idea if the other seeds are going to die or start sprouting. Once a couple start sprouting, then there's a good chance more will sprout, so surgery would not be beneficial because you can't keep going in and surgically removing them as they pop up. But, as in dandilions, you could throw weed poison at them and perhaps kill the sprouting dandilions and the seeds that haven't sprouted. Dandilions are hardy weeds so some may survive the weed poison. The same with cancer... the chemo may kill off any of the new ones sprouting up, and the seeds that haven't taken root... then again, some may survive that poison.

    So, I guess it's a matter of trying different weed poisons/chemo drugs and hope they can kill off the weeds without destroying the fertile ground.

    One of the positives I can personally think of when it comes to chemo treatments.... chemo is "systematic". You may be treating nodules in the lung or the liver with chemo, but in reality, the chemo is going throughout your whole system. So if there are some cancer cells thinking of taking root in other parts of the body, the chemo may just catch those and kill them without you even knowing that's what's happened.

    I meet with my oncologist next Friday to go over the results of my latest PET scan. We already know I have 1 1/2" nodule in my lung, as well as 4 very small "suspicious" nodules in my lungs, so it's looking like I'll be going back on chemo to try and kill off the suspicious small nodules... before attempting surgery on the larger 1/2" nodule. I'll know more what our plan is next Friday.
  • taraHK
    taraHK Member Posts: 1,952 Member

    Thanks, everyone... I'm finding this whole discussion very interesting and each of the explanations is helping me understand this cancer jargon a bit more. For some reason, I had assumed that "recurrence" was something that this particular cancer (colon) had a high risk of. But that once it started spreading, then that made it different and more dangerous, so to speak.

    But it does make sense that it's all really an ongoing progression of the same thing. If you are diagnosed with a primary cancer, then my understanding is you are not "cured" until you can go NED for 5 years without a recurrence/spread. So each time they find something, then it's a matter of dealing with that which they've found and treating it.

    So am I correct in thinking that as long as they are treating your current growths/tumours, be it with chemo/drugs, radiation or surgery, it doesn't really matter if it has metasticized or is called a recurrence, treating it is a continuation of trying to get rid of the nasty monster.

    My lung surgeon gave me an analogy that made sense as to why a surgeon might not recommend surgery. In the case of the lungs, if you only have one growth, then it might be beneficial to go in and take that growth out. If you have one known growth and a couple of small ones that are just big enough to be seen on a CAT or PET scan, then this might be the sign of more to come. He said it's like throwing a handful of dandilion seeds on the ground. If you see one dandilion, you can pluck it out by the roots and have no idea if the other seeds are going to die or start sprouting. Once a couple start sprouting, then there's a good chance more will sprout, so surgery would not be beneficial because you can't keep going in and surgically removing them as they pop up. But, as in dandilions, you could throw weed poison at them and perhaps kill the sprouting dandilions and the seeds that haven't sprouted. Dandilions are hardy weeds so some may survive the weed poison. The same with cancer... the chemo may kill off any of the new ones sprouting up, and the seeds that haven't taken root... then again, some may survive that poison.

    So, I guess it's a matter of trying different weed poisons/chemo drugs and hope they can kill off the weeds without destroying the fertile ground.

    One of the positives I can personally think of when it comes to chemo treatments.... chemo is "systematic". You may be treating nodules in the lung or the liver with chemo, but in reality, the chemo is going throughout your whole system. So if there are some cancer cells thinking of taking root in other parts of the body, the chemo may just catch those and kill them without you even knowing that's what's happened.

    I meet with my oncologist next Friday to go over the results of my latest PET scan. We already know I have 1 1/2" nodule in my lung, as well as 4 very small "suspicious" nodules in my lungs, so it's looking like I'll be going back on chemo to try and kill off the suspicious small nodules... before attempting surgery on the larger 1/2" nodule. I'll know more what our plan is next Friday.

    Weed Wacker
    A very interesting discussion. CherylHutch: I like that dandelion comparison. I'm someone who has plucked a few dandelions (surgery for lung mets) and is currently using weed poison, to try again to wipe out the seeds -- for once and for all. Maybe we should call ourselves WeedWackers! Good luck to you with your "gardening" -- Best wishes Tara
  • apache4
    apache4 Member Posts: 272 Member
    Excellent
    That is a great analogy, Cheryl, and it is similar to what I have had explained to me.
    Thanks for posting it.