Recurrent cancer

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Recurrent cancer is a form of

tumor may become the site of cancer’s return or it may spread to another part of the body.[1] These surviving cells accumulate various genetic changes over time, eventually producing a new tumor cell. It can take up to weeks, months, or even years for cancer to return. Following surgery and/or chemotherapy or radiotherapy, certain tumor cells may persist and develop resistance to treatment and eventually develop into new tumors. Age, sex, cancer type, treatment duration, stage of advancement, and grade of original tumor are some of the factors that determine the rate of cancer recurrence.[2][3] If recurrent cancer has already moved to other body parts or has developed chemo-resistance then it may be more aggressive than original cancer. In general, the severity of cancer increases with a shorter duration of time between initial treatment and its return.[3]

Cancers with the highest recurrence rates include

Epithelial ovarian cancer with a recurrence rate of 85%,[5] and Bladder cancer with a recurrence rate of 30-54%[6]

Types

There are three types of recurrent cancers:

Causes

Cancer stem cells

tumor microenvironment's specialized niches. CSCs have so far been found in a variety of tumors, including those of the brain, breast, ovary, head and neck, etc..[15][16][17][18][19]

CSCs have the ability of self-proliferation just like regular stem cells. A single CSC can divide asymmetrically into one CSC and one differentiated tumor cell. The tumor is majority made up of the latter cells.[20]

In some cancers CSCs are quiescent for long period of time, making them ineffective to the treatment. Therefore, even decades after the primary cancer has been fully treated, the reactivation of the inactive CSCs may lead to tumor recurrence.[21][22]

Neosis

karyokinesis, asymmetric intracellular cytokinesis and the generation of Raju cells, which are tiny mononuclear cells having stem cell like characteristics. These cells play a role in cancer recurrence and therapy resistance.[23]

Phoenix rising

Phoenix rising is a process by which dead cells send signals that promote growth and division, generating new cells.[24] After a tissue injury, stem cells present in and around the injured tissue play a crucial role in replenishing the damaged ones. It is theorized that molecules released from wounded cells trigger stem cells' migration to that site, followed by differentiation and proliferation.[25] Through the process of apoptosis, the dying tumor cells provide growth signals and repair radiation-damaged tumors. PGE2 is released by apoptotic cells in a caspase-dependent manner, which aids cancer stem cells and cancer progenitor cells in expanding and multiplying.[26]

Diagnosis

Early diagnosis of recurrence is important and can improve the prognosis and survival of patients with cancer.

Malignant tumors develop and secrete biologic chemicals known as tumor markers that are detectable in the bloodstream. These markers might ideally be used to screen for cancer, diagnose it, and track how effectively it responds to treatment.[30]

Treatment

The inherent limits of current cancer therapy approaches usually result in treatment failure. Chemotherapy and radiation therapy resistance is a common factor in the failure of treatment for many cancers.[31] Additionally, because most treatments cannot completely eradicate CSCs, many methods that are not adequately selective against CSCs might be harmful to healthy tissues, and patients frequently run the risk of recurrence and metastasis.[32]

Recent years have seen the development of numerous treatments with the goal of eliminating CSC. Targeting CSC surface markers, the ABC cascade, the

signal cascades could all help kill CSCs. There are numerous drugs targeting these markers or pathways, which are being tested in clinical trials. The treatment varies from cancer to cancer and patient to patient.[33][34][35][36]

References

  1. ^ "https://www.cancer.gov/publications/dictionaries/cancer-terms/def/recurrent-cancer". www.cancer.gov. 2011-02-02. Retrieved 2022-10-07. {{cite web}}: External link in |title= (help)
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  3. ^ a b "Cancer Recurrence - Why Does Cancer Come Back". Cancer Treatment Centers of America. 2021-07-15. Retrieved 2022-10-07.
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