Which gynaecological cancers are most likely to recur?
When a cancer returns after initial treatment, this is called a recurrence. Cancers that are diagnosed at a more advanced stage are more likely to recur, regardless of the type of gynaecological cancer.
To monitor for any cancer recurrence, patients will have follow-up visits with their gynaecological oncologist for up to 5 years at varying intervals, depending on the stage and extent of their disease. If the oncologist is confident they have caught the cancer early (stage 1), and removed all signs of disease, less follow-up visits are necessary.
The gynaecological cancer patients with the highest risk of recurrence are usually ovarian cancer patients. This is because most patients with ovarian cancer are diagnosed at stage 3 or higher, when the cancer has spread outside of the ovary, making it harder to treat.
About 70% of patients with advanced ovarian cancer will develop a recurrence within three years of initial treatment.
If ovarian cancer recurs after initial treatment, it can either be localised to one part of the body, or as a wide-spread recurrence.
In Australia, the overall five-year survival rate for women diagnosed with ovarian cancer is 48%, the lowest survival rate of all the gynaecological cancers. The mainstay of ovarian cancer treatment is surgery and chemotherapy. You can read more about ovarian cancer treatment here.
Preventing a cancer recurrence
Unfortunately, after initial treatment for the cancer, which may include surgery and/or chemotherapy and/or radiation treatment, there isn’t much you can do to prevent a cancer returning, even with improved lifestyle choices. Healthy diet and regular exercise can help boost your immune system and prevent new health problems, but currently there’s no evidence this will prevent the disease from returning. In my previous blog, I discuss complementary cancer therapies that can help improve quality of life and manage symptoms during treatment but are unlikely to prolong survival. Your medical care team will also discuss screening options after primary treatment. While population-based screening is available for cervical cancer, not all gynaecological cancers have reliable screening options.
Follow-up will not protect from recurrence. However, attending regular follow-up visits will allow your doctor to monitor for any recurrence, which are more likely within the first 5 years after initial treatment. Monitoring any unusual changes you notice about your body between visits will help to treat any potential recurrences as early as possible.
Some patients’ risk of recurrence is very low. For those patients, regular follow up visits are simply not worth it. Those patients will do much better to watch out for symptoms such as bleeding, pain or new onset of unexplained fatigue. For example endometrial cancer patients with very early stage disease have a very low risk of relapse.
Fear of recurrence
Dealing with the fear that cancer could return can be difficult, and while your medical team can provide a prognosis, it’s not possible to provide 100% certainty whether the cancer may return. Mind-body therapies provided by psychologists can also help to provide techniques to control your fears.
If cancer does recur, there is still treatment available. These treatments could be surgical removal, chemotherapy or radiation treatment. Patients might have time periods when they are cancer-free (called remission) that alternate with periods of new cancer growth (recurrence).
If a cancer is advanced, and a cure may not be possible at this stage, many women can live for an extended time with a good quality of life due to the advancements in cancer treatments available.
In summary, the likelihood of a cancer returning doesn’t depend on the cancer type alone, but also the stage and grade of the original cancer, and which treatments you received.
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