France recorded around 52,777 new cases of lung cancer in 2023, this cancer being mainly caused by smoking (according to the National Cancer Institute). Once the diagnosis has been made, patients benefit from multidisciplinary care, with three main treatments, namely surgery, radiotherapy and drug treatments. In some of them, treatments do not completely kill the cancer cells, and the cancer reappears in the months or years following the end of treatment. The diagnosis of recurrence of lung cancer is then raised, and new multidisciplinary care is necessary.
1. Recurrence of lung cancer: definition, cause and frequency
Lung cancer, or bronchopulmonary cancer, is the second most common cancer in men and the third in women (according to the National Cancer Institute). Depending on the cells in the bronchi affected, doctors distinguish two forms, namely small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). The latter represent 15% and 85% of lung cancers, respectively. In some patients, treatments do not eliminate all the cancer cells, and the cancer returns several months or even years later. Typically, lung cancer recurrence occurs within two years, with the chances of relapse decreasing after that. The cancer may come back in the same area or in another part of the body. People who have been diagnosed with non-metastatic NSCLC and who have undergone surgery have a 30 to 55% risk of experiencing a recurrence (according to the Institut Curie).
Although it is impossible to predict a relapse, certain factors can explain it:
- non-compliance with recommended preventive measures: stopping smoking (mainly), poor eating habits, irregular medical monitoring, etc. ;
- difficult-to-access cancer cells that have escaped cancer treatments;
- damage to the mediastinal lymph nodes;
- metastases: relapse in the area of the lungs linked to another cancer;
- etc.
2. Symptoms of lung cancer recurrence
People affected by a recurrence of lung cancer may experience various clinical manifestations:
- Non-specific respiratory symptoms: persistent and unexplained cough, shortness of breath, difficulty breathing, chest pain, voice change (hoarse or hoarse voice), bloody sputum (hemoptysis), wheezing.
- Non-respiratory symptoms: unexplained persistent fatigue (asthenia), unexplained loss of appetite and/or weight, swelling of the neck and eyelids, recurring headaches, high blood pressure, significant weight gain due to water retention, etc. .
After lung cancer, people must be closely monitored throughout their lives. They are offered scheduled appointments with the specialist who has been following them regularly. These visits offer them the opportunity to take stock of their state of health, discuss possible clinical signs and carry out certain check-ups. It should be noted that some symptoms of lung cancer recurrence can be confused with long-term side effects of treatments. The specialist is able to provide answers to the patient. If a suspicious symptom appears between two scheduled appointments, it is imperative to consult the attending physician. In the event of a relapse, it is necessary to be able to make a diagnosis as early as possible, in order to establish rapid multidisciplinary consultation.
3. Prognosis of lung cancer recurrence
It is important to emphasize that lung cancer is a difficult cancer to treat, with a particularly high mortality rate. Today, it is the deadliest cancer in France, and its standardized net survival at 5 years was estimated at 20% between 2010 and 2015 (according to the National Cancer Institute). If there is a recurrence, the prognosis depends on several factors, particularly the type and stage of lung cancer at the time of initial diagnosis, as well as the patient’s overall health.
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