Recurrent course. Cancer recurrence after surgery: symptoms, methods of prevention. What does relapse mean in medicine?

RECURRENCE of the disease (lat. recidivus recurrent) - resumption, return of the clinical manifestations of the disease after their temporary disappearance.

R.'s occurrence is always associated with incomplete elimination of the causes of the disease during its treatment, which, under certain unfavorable conditions, leads to the re-development of pathogenetic processes characteristic of this disease (see), and a corresponding resumption of its wedge, manifestations.

Designating the course of the disease as recurrent necessarily presupposes the presence of periods of remission between the periods of return of the disease (see), the duration of which ranges from several days (for infectious diseases) to several months, and in certain cases (usually for non-infectious diseases) - even up to several years. The duration of remission and the likelihood of R.'s occurrence are largely determined by the degree of compensation for the functional insufficiency of various systems that remain after incomplete recovery (see) or were genetically determined, as well as the influence of the environment. If the activity of various body systems is not fully restored, R.'s occurrence is possible under normal conditions, but in some cases only extreme conditions can lead to R.'s disease.

Gout, certain forms of arthritis (see Arthritis), rheumatism (see), peptic ulcer (see); It is customary to talk about the recurrent course of hron. bronchitis (see), chronic. pancreatitis (see), about recurrent (recurrent) forms of schizophrenia (see). A recurrent course is characteristic of a number of diseases of the blood system, such as acute leukemia (see), pernicious anemia (see), etc. For certain diseases, the occurrence of relapse is so characteristic that it is reflected in their name, for example, relapsing fever (see .), recurrent paralysis (see).

Wedge, the picture of R.'s disease in comparison with its primary manifestations can vary significantly both in the degree of severity of symptoms and in qualitative terms. For example, rheumatism that occurs for the first time can occur in the form of chorea, and subsequent R. - in the form of polyarthritis, rheumatic carditis, etc. In severe R., symptoms of complications, for example, heart failure, can dominate, dramatically changing the wedge, the picture of the underlying pathology.

In case of certain recurrent infectious and non-infectious diseases, the course and characteristics of R. are taken into account when establishing their diagnosis and carrying out differential diagnosis (typicality of symptoms in relapses of malaria, gout, seasonality of relapses of duodenal ulcer, etc.). In some cases, vagueness, atypicality, or long-standing primary manifestations of the disease can lead to incorrect interpretation of R. as the onset of the disease. Therefore, in diseases prone to a recurrent course, the basis for R.’s diagnosis is always a careful collection of anamnesis (see), sometimes with a critical reassessment of diagnoses of previously suffered diseases based on a retrospective analysis of their symptoms and course (see Diagnosis, Diagnostics).

Treatment of R.'s disease is determined by the nature of the underlying pathology, the presence of functional disorders acquired during the entire course of the disease, as well as complications (see) accompanying this relapse. Remission is achieved the easier the earlier R.'s treatment is started, therefore, in cases of a disease with a recurrent course, the patient should be informed about the possibility of R.'s occurrence and the need for timely consultation with a doctor.

Prevention of R. occupies an important place in the system of secondary prevention of diseases (see Prevention). It begins with full therapy of the first acute phase of the disease, which in some cases makes it possible to achieve complete recovery and prevent the transition of the pathological process (see) to chronic. form, and in others contributes to the maximum preservation or the most complete compensation of functions impaired by the disease, which reduces the likelihood of R. In many cases, a significant role in the prevention of R.

play measures for the rehabilitation of the patient after the acute phase of the disease, carried out taking into account the form and characteristics of the pathology, as well as the individual characteristics of the body, lifestyle and habits of the patient (see Rehabilitation). General health measures are of great importance, including balanced nutrition, physical education, proper employment, and elimination of bad habits. In case of infectious and allergic pathology, preventive measures are taken to promote the formation of immunity: hardening, various forms of stimulating therapy (see), in particular protein therapy (see), in some cases - the use of vaccines, gamma globulins (see Immunoglobulins), the appointment of hyposensitizing funds, etc.

For diseases that are prone to recurrence at certain times of the year, seasonal prevention of rheumatism is carried out. In the USSR, for example, prevention of rheumatism is carried out in the spring and autumn (the use of bicillin, anti-inflammatory drugs). If R. of peptic ulcer disease is seasonal, then 2-3 weeks before the expected onset of R. the patient is recommended to have a stricter diet than during the period of remission, taking alkaline mineral waters, belladonna preparations, vitamin preparations, etc. Such preventive measures prevent the development of R. or significantly reduce the degree of its wedge, manifestations.

The possibility of preventing R. and reducing their severity with timely treatment necessitates clinical observation of patients with recurrent forms of the disease (see Medical examination).

Relapse of infectious diseases. In infectious diseases (see), R.'s occurrence is due to the persistence of the pathogen in the patient's body after the initial infection. In this way, R. differs from reinfection (see) - repetition of the disease due to repeated infection, which is observed in Ch. arr. with inf. diseases, as a result of which a person does not develop stable immunity (see). Various individual immunity disorders, congenital or acquired immunological deficiency (see), decreased body resistance (see) can cause both reinfection and the transition of inf. diseases in chronic form or formation inf. allergies with the development of various forms of hron. pathologies characterized by a relapsing course. Complex clinical and immunological studies of cellular and humoral immunity in inf. patients show that the possibility of developing R. increases in cases where low or negative titers of agglutinins are observed during the period of the underlying disease, which is associated with inhibition of their formation. This puts forward the need to use such methods of treatment, which would actively influence immunogenesis. However, there is evidence that an artificial increase in antigenic stimulation, although manifested by an increase in agglutinin titer, does not always prevent the development of relapse. On the other hand, an increase in the phagocytic activity of leukocytes during inf. diseases has a prognostically favorable value. A certain role in the occurrence of R. can be played by the reversion of the L-forms of the pathogen (see L-forms of bacteria) with the restoration of its virulence (typhoid fever, erysipelas, meningococcal infection).

The development of R. is facilitated by late hospitalization, inadequate treatment, violation of the regime and diet, concomitant diseases, exo- and endogenous nutritional disorders, hypovitaminosis, helminthiasis and other factors. In some cases, for example, with typhoid-paratyphoid diseases, the number and frequency of R. increase with the use of antibiotics. The reasons for this may be early (unreasonable) withdrawal of the drug, as well as suppression of the body’s immune reactions by antibiotics. When antibiotics are used, R. usually occurs at a later date.

R. with inf. Diseases are distinguished by frequency and timing of occurrence. Some infections are characterized mainly by a single occurrence of R. (anicteric forms of leptospirosis), others - multiple times (dysentery, erysipelas, typhoid fever). Early R. are characterized by the resumption of symptoms of the disease several days after the disappearance of the main manifestations of the disease; late R. (for example, with erysipelas, brucellosis) can occur in a very distant period.

A recurrent course is typical for such inf. diseases such as typhoid and relapsing (tick-borne and louse-borne) typhus, paratyphoid A and B, salmonellosis, dysentery, malaria, viral hepatitis, brucellosis, etc.

Wedge, manifestations of R. with inf. diseases are in many ways similar to the symptoms of the underlying disease. In most cases, R. occurs in a milder form than the primary manifestation of the disease, its duration is shorter, although sometimes a more severe and prolonged course is observed. With R., there may be a “loss” of individual symptoms characteristic of this inf. disease, and in some cases it manifests itself in a different wedge form (for example, R. after the gastrointestinal form of salmonellosis can occur in the form of its septic form).

Treatment of patients with recurrent inf. disease should consist of the complex use of antibiotics, vaccines and other stimulants of immunogenesis (see Immunotherapy, Infectious diseases). In addition, it is necessary to exclude provoking factors, as well as prescribe antihistamines and nonspecific agents that increase the body's resistance to the infectious agent.

Tumor relapse is considered to be the resumption of its growth at the site or in the area of the former tumor some time after radical surgical, radiation or other treatment aimed at tumor destruction, for example, electrocoagulation (see Diathermocoagulation.), cryodestruction (see Cryosurgery). In certain types of neoplasms (lymphogranulomatosis, chronic lympho- and myeloid leukemia, chorionepithelioma, seminoma, etc.), when long-term remission or cure is possible as a result of conservative therapy, resumption of the disease is interpreted as R. Development of metastases (see Metastasis) through various the period after cure of the primary tumor is designated as disease progression. Metastasis differs from R. tumor in that it is localized outside the operation area in distant lymph nodes and parenchymal organs (liver, lungs, kidneys, etc.) or manifests itself in the form of tumor dissemination.

A distinction is made between early R., which occurs during the first months, and late R., which occurs after 2-3 years. R. at later dates are rare. R. can be caused by tumor cells and their complexes located outside the remote part of the organ and irradiation fields, micrometastases in partially preserved regional lymph nodes, dissemination of tumor cells during mobilization and damage to the tumor during surgery, radioresistance of individual cells and their populations during radiation therapy , primary multiplicity of tumor primordia in one organ. The occurrence of true R. cannot be distinguished from the growth of micrometastases (implantation in the area of operation, regional in lymph nodes of the same area), therefore the resumption of tumor growth in the area of the former operation is defined as a relapse.

R. tumors can be single or multiple, localized directly in the scar or anastomosis, at the site of a former tumor or in the area of the surgical field, and occur repeatedly.

The frequency and nature of R. tumors (see) depend on gistol. the form of the neoplasm, the radicality of the treatment, the primary localization of the tumor, its stage, the nature of growth, the degree of differentiation of tumor cells, the state of the patient’s body’s defenses.

After removal of benign tumors, R. are rare; their occurrence is associated with non-radical surgery or multicentricity of tumor primordia (polyposis of the mucous membrane of the stomach and colon). However, the frequency of recurrence of such benign tumors as myxoma, embryonal fibroma and lipoma does not differ from the frequency of recurrence of malignant tumors.

Malignant tumors have a particular recurrence rate. Among skin neoplasms, basal cell carcinomas and squamous cell carcinomas are prone to R., and among soft tissue tumors R. of synovial fibrosarcomas, rhabdo- and leiomyosarcomas are common. R. of malignant bone tumors (chondrosarcoma, osteogenic sarcoma) occur during insufficiently radical operations due to tumor growth into soft tissues and the spread of the process along the bone marrow canal. Local R. of breast cancer arise in the form of single and multiple nodes in the area of the former operation. R. tumors went.-intestinal. tract, for example, stomach cancer, are more common in cases where resection was performed in the area of tumor tissue. At the same time, the risk of R., according to N. N. Blokhin (1981), increases if the level (line) of resection is close to the tumor up to 1-3 cm, as well as when the tumor is localized in the upper third of the stomach, in stages II - III diseases, rapid development, endophytic and mixed forms of its growth. If R. of colon cancer are rare and are the result of a non-radical operation, then in case of rectal cancer they occur in the area of scars and soft tissues of the perineum, more often after resection than after bowel extirpation. R. of lung cancer occurs in its central form, more often after lobectomy, if the level of resection takes place near the tumor node. In R., the tumor is located in the stump of the corresponding bronchus, growing into its lumen or peribronchially. The latter is usually a consequence of tumor germination from incompletely removed metastases in lymph nodes. R. is especially common after radiation therapy for adenocarcinoma and poorly differentiated lung cancer.

During the first two years after treatment, it can be difficult to establish the true cause of progression of the tumor process (relapse or metastasis), especially for tumors of the cervix and uterine body. In these cases, a recurrent neoplasm, regardless of the location of its appearance, is more often regarded as R.

R.'s treatment of malignant tumors is often conservative with the use of radiation therapy (see) and antitumor drugs (see, Antitumor drugs), which mainly gives a palliative effect. The need for surgical and combined treatment of R. after previous radiation therapy rarely arises. This happens mainly with tumors of the skin, soft tissues, bones, stomach, colon, and less often in other localizations.

Prevention of R. tumors consists of both early diagnosis and timely surgical treatment for locally limited tumors, and adherence to the principles of ablastics (see Tumors): the most complete removal of the tumor at a considerable distance from its borders within healthy tissues, regional lymph nodes, thorough washing of the surgical wound in order to mechanically remove tumor cells to prevent their implantation. For certain tumors (cancer of the skin, larynx, esophagus, rectum, cervix, etc.), preoperative radiation therapy can reduce the frequency of R., for others (ovarian cancer, breast cancer, soft tissue sarcomas) - the frequency of R. can reduce postoperative therapy with antitumor drugs.

For the timely detection of R. tumors and rational treatment, clinical examination of cancer patients is important. Its role is especially great in cases where it is possible to predict the progression of the disease during the first two to three years after radical surgical treatment and radiation therapy.

V. P. Zhmurkin; S. G. Pak (inf.), A. I. Pirogov (onc.).

Relapse

Relapse is a repetition, return of clinical manifestations of the disease after their temporary weakening or disappearance. The concept of relapse was used to designate the phase of clinical exacerbation of predominantly infectious diseases, in which the return of the disease is associated with the persistence of the pathogen in the patient’s body after the initial infection. This differs from relapse from reinfection - recurrence of the disease due to re-infection. In the origin of both relapse and reinfection, the insufficiency of the developing immunity is of decisive importance (see). The development of relapse is possible in many infectious diseases, in particular in abdominal and relapsing (tick-borne and louse-borne) typhus, paratyphoid fevers A and B, dysentery, malaria, epidemic hepatitis, brucellosis, etc.

Currently, the concept of relapse is used more widely. Relapse also includes returning to using an addictive substance, such as smoking cigarettes.

Relapses are spoken of when there are repeated clinical manifestations of non-infectious diseases, if their treatment does not completely eliminate the causes of the disease that cause the recurrence of its clinical manifestations under certain conditions. Thus, it is customary to talk about the recurrent course of peptic ulcers, rheumatism, chronic pneumonia, recurrent (recurrent) forms of schizophrenia, and relapses of malignant neoplasms. For some diseases, the relapsing course is so characteristic that it is reflected in their name (relapsing fever, relapsing paralysis).

Designating the course of the disease as recurrent necessarily presupposes the presence of periods of remission between periods of return of the disease (see), the duration of which for infectious diseases ranges from several days to several months, and for non-infectious diseases - even up to several years. A relapsing course should be distinguished from a cyclic course, when a change in recurring clinical phases of the disease occurs without remission.

The severity of clinical manifestations during relapse varies from asymptomatic to severe with the development of complications. Therefore, treatment of the disease in the relapse phase is no less responsible than in the first acute phase of the disease, and the earlier it is started, the more successful it is.

For the diagnosis of relapse, the most significant role is played by anamnesis (see), with the help of which the time and nature of the primary manifestations of the disease and the frequency of its course are established.

Prevention of relapse of infectious diseases largely depends on the correct treatment of diseases in their acute phase, primarily on the choice of antibacterial drugs, their dose and duration of administration. An important role is played by measures that promote the formation of immunity - rational nutrition, desensitizing agents, vitamins, restorative procedures, and in some cases - the use of vaccines.

For diseases that are prone to recurrence in certain seasons of the year, seasonal relapse prevention is used in Russia, for example, relapse prevention in people suffering from rheumatism is carried out in the spring and autumn (the use of bicillin together with anti-inflammatory drugs). If the seasonal nature of the relapse is established by the anamnesis of a patient with peptic ulcer disease, then 2-3 weeks before the expected onset of the relapse, the patient is recommended to have a stricter diet than during the period of remission, taking alkaline mineral waters, belladonna, and vitamin preparations. Such preventive measures prevent the development of relapse or significantly reduce the degree of its clinical manifestations. The possibility of preventing relapses and reducing their severity with early treatment necessitates clinical observation of patients with recurrent forms of diseases (see. Clinical examination). Depending on the nature of the disease, during the period of remission the patient is given medical recommendations on the general regimen, diet, preventive medication, etc., the correct implementation of which is monitored by a nurse.

Relapse

1. Small medical encyclopedia. - M.: Medical encyclopedia. 1991-96 2. First aid. - M.: Great Russian Encyclopedia. 1994 3. Encyclopedic Dictionary of Medical Terms. - M.: Soviet Encyclopedia. - 1982-1984

See what “Relapse” is in other dictionaries:

RECURRENCE - (lat., from recidere to return, to resume). 1) return of the disease. 2) repetition of the same crime for which there was a conviction. 3) generally returning to something. Dictionary of foreign words included in the Russian language. Chudinov A.N.,... ... Dictionary of foreign words of the Russian language

RECURRENCE - RECURRENCE, relapse, husband. (lat. recidivus returning). 1. Resumption, return, repetition of something (usually unwanted). Relapse of illiteracy. 2. A new manifestation of the disease after its apparent or incomplete cessation (med.).... ... Ushakov's Explanatory Dictionary

relapse - a, m. recidive f., German. Rezidiv lat. recidivus returning. 1. Recurrence of the disease after an apparent complete recovery. ALS 1. Relapse or recurrence, return of an attack of the disease, a secondary attack, relapse into a past disease, belching of the disease ... Historical Dictionary of Gallicisms of the Russian Language

RECURRENCE - (from Latin recidivus returning) return of the disease, i.e. its repetition in a typical form immediately after recovery or during the recovery period. As a rule, however, R. emerges as an exact repetition of the former; it usually runs shorter and... ... Big Medical Encyclopedia

Recidivism - see Recidivism of crimes ... Encyclopedia of Law

RECURRENCE - (from the Latin recidivus returning), return, repetition of a phenomenon after its apparent disappearance. For example, in medicine, the return of a disease after remission ... Modern encyclopedia

RECURRENCE - (from Latin recidivus returning) 1) in medicine Return of the clinical manifestations of the disease after remission. 2) Return, repetition of a phenomenon after its apparent disappearance ... Big Encyclopedic Dictionary

RECURRENCE - RECURRENCE, ah, husband. (book). 1. Return of the disease after its apparent cessation. R. radiculitis. 2. Repeated manifestation of something. (negative). R. crimes. Relapses of melancholy. | adj. recurrent, oh, oh. Ozhegov's explanatory dictionary. S.I. Ozhegov,... ... Explanatory Dictionary of Ozhegov

RECURRENCE - male, lat. return, repetition of the same illness, seizure. Dahl's Explanatory Dictionary. IN AND. Dahl. ... Dahl's Explanatory Dictionary

Relapse - activation of the pathological process, incl. infection, occurring after a previous remission (see). Characteristic of chronic diseases with imperfect immunity, but sometimes occurs in acute diseases, when, as a result of a mild course... ... Microbiology Dictionary

Books

Recidivism by Jesse Russell. This book will be produced in accordance with your order using Print-on-Demand technology. High Quality Content by WIKIPEDIA articles! Recidivism of crimes in criminal law is the commission of… Read more Buy for 1125 rubles
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Relapse - what is it? Relapse of the disease

Relapse in medicine is the return of the entire set of clinical manifestations of a particular disease or their worsening, which occurs after a state of remission (improvement). What can trigger a relapse, how it progresses and is diagnosed, will be discussed later in the article.

Relapse is characteristic not only of infectious diseases

For a long time, doctors called a relapse only an exacerbation of infectious diseases. And by this they meant the return of the disease, caused by the pathogen remaining in the body after the first infection. By this criterion, by the way, relapse was distinguished from reinfection - repeated infection occurring due to immature immunity.

Recently, this term has been used more widely. Relapse is repeated clinical manifestations of any disease in cases where the causes of the disease are not completely eliminated during treatment. For example, it is now customary to talk about the recurrent course of rheumatism, gout, peptic ulcers, chronic pneumonia, bronchitis, pancreatitis, the recurrent form of schizophrenia, as well as relapses of cancer.

By the way, for some ailments such a course is so typical that it is even included in their name: relapsing fever, recurrent paralysis, etc.

The essence of relapse

But the disease is considered recurrent under one condition - between exacerbations it must have, as mentioned above, a period of remission. Moreover, it may be complete, but it may also retain some symptoms of the existing disease.

In infectious diseases, such a “lull” can last several days or months, and in non-infectious diseases, even several years. This depends largely on the compensatory capabilities of various body systems, the genetic cause of each disease, as well as the influence of external factors.

Moreover, often a relapse is a condition in which the clinical picture of the disease may differ significantly from that present during the period of its first manifestation. For example, relapses of heart failure may demonstrate the dominance of complications of this pathology, which dramatically changes its clinical picture.

Reasons for relapse

The risk of the disease returning depends on many factors. The most common reasons for relapse are:

features of the course of the disease itself - its cyclical nature, such as, for example, relapsing fever, malaria, gout or peptic ulcer;
incomplete treatment (a striking example is cancer);
weakened immunity as a result of stress or hypothermia (this happens with herpes or eczema);
accompanying illnesses;
non-compliance with doctor's recommendations (for example, violation of the prescribed diet for colitis or ulcers);
untimely hospitalization.

The causes and characteristics of relapses can be most clearly examined using the example of diseases caused by malignant neoplasms.

Types of cancer recurrence

It is important to know that in medicine there is a distinction between relapse of the entire cancer disease and relapse of the tumor. The latter means the resumption of growth of the tumor in the same place from the cells preserved after treatment. Most often, this is due to the imperfection of the treatment, but sometimes it is also a feature of this type of tumor - the so-called primary multiplicity, in which it begins from several foci located in one organ.

The development of metastases at different times after getting rid of the primary tumor is characterized as progression of the entire disease. Metastases can form outside the treatment area - in distant lymph nodes or in organs with parenchyma (liver, kidneys, lungs, brain, etc.).

Various types of cancer recurrence are not always asymptomatic - patients notice the appearance of a new nodule in an unusual place or the manifestation of familiar signs. And relatives can pay attention to the patient’s emerging anemia, weakness and causeless depression - naturally, all this requires an unscheduled visit to an oncologist and the start of a new stage of treatment.

What types of cancer have frequent recurrences?

Oncological pathologies have varying degrees of susceptibility to relapse. Thus, with skin cancer, squamous cell carcinoma and basal cell carcinoma most often return, and with tumors in soft tissues, fibrosarcoma and liposarcoma have the highest risk of recurrence.

In cases with malignant neoplasms in bone tissue (chondrosarcomas), cancer recurrence may occur as a result of the spread of pathological cells along the bone marrow canal or their growth into soft tissues after insufficiently radical surgery.

And in breast cancer, relapse manifests itself in the form of single or multiple nodes in the previously operated area.

The possibility of relapse is difficult to establish

Of course, after radiation, chemohormonal therapy or surgery, there may not be a relapse, but, unfortunately, no oncologist can give a 100% guarantee that this will not happen to the patient. By the way, it is quite difficult to establish the true cause of the resumption of the tumor process during the first 2 years after treatment.

True, the peculiarities of the course of the disease and the condition of the patient’s body can help the doctor predict the likelihood of recurrence of the disease. The specialist takes into account some determining factors.

What signs determine the possibility of relapse?

First of all, pay attention to the stage of the tumor at the time of treatment. Although it is very difficult to determine the exact spread of cancer cells in patients at stage 1 of the disease who have undergone radical therapy. Therefore, they should undergo mandatory examinations every 3 months for 2 years. In addition, the following factors are important:

Localization of the tumor. For example, skin cancer (especially at stage 1 of the disease) has an almost 100% positive outcome, and recurrence of cancer of the inner quadrant of the breast is more likely than if the tumor is located in the outer quadrant, etc.
The structure of the neoplasm and the form of tumor growth. Thus, in skin cancer, the superficial form of the tumor grows very slowly and does not metastasize for many years. And for lung cancer, the worst prognosis is observed for its poorly differentiated form.
Nature and extent of treatment provided. The most favorable results are obtained by a combination therapy method.
Age of patients. At a young age, metastasis occurs faster and is more severe than in older people.

As you can see, relapse is a combination of many factors that lead to the resumption of the disease. This means that observation by a doctor and timely detection of signs of relapse will help ease its course, and in some cases, prevent the onset of the disease process.

Cancer relapse: what is it and how does it manifest?

There are several methods for eliminating cancerous tumors, but the effective ones, those used more often than others, are radiation, chemotherapy and surgery.

If after the operation the tumor reappeared, or the chemotherapy was gentle and the cancer reappeared, then this is what the doctor will mean when uttering the phrase “cancer recurrence.”

The focus of the tumor arises from the remaining elements of the removed tumor, spread in the body as a result of metastases or in some other way. There may be several reasons for this, which we will discuss below.

Previously, the term “relapse” was used only for infectious diseases, denoting the return of pathology, the cause of which was the remains of the pathogen present in the patient’s body. This distinguished it from reinfection - a case when the disease developed again, but “from scratch.”

However, now the term has become more widely used, and implies a pathological state of the body during the period of repeated manifestations of various diseases, the causes of which have not been completely eliminated. Cancer relapse is a periodic phenomenon in oncology, but in addition to it, relapses of rheumatism, ulcers, pneumonia, bronchitis and other diseases often occur, and for some, relapse is so common that it has become part of their usual name: relapsing paralysis, relapsing fever and other diseases.

The essence of relapse is that re-development occurs after a period of remission, which can be complete or partial, with weakened signs of pathology.

Reasons for relapse

There are actually many factors influencing the recurrence of the cancer process, and the main reasons are:

Treatment does not reach the final result (incomplete course of therapy);
Cyclical exacerbation of pathology;
Secondary diseases that are concomitant;
Weak body resistance;
Delayed hospitalization;
Violation of doctor's recommendations.

The history of family illnesses and a person’s lifestyle also play a certain role. But the main factors on which cancer recurrence depends are:

The younger the patient, the greater the risk of relapse, subject to methods such as chemotherapy and radiation. But the chance of developing a malignant tumor increases with the patient's age. This group includes even those people who have not had cancer before.

Radiation is dangerous for children due to the structure of the body, which differs from the anatomical features of an adult.

Chemotherapy can be gentle, or, on the contrary, high doses of drugs such as Mechlorethamine, Cyclophosphamide or Procarbazine can affect the occurrence of relapse.

The process of division of healthy cells can develop into a malignant tumor formation. In particular, this occurs due to treatment methods.

An increase in relapse rates has been observed with stem cell transplantation.

Symptoms of oncology

Basically, the general symptoms that a relapse process is occurring are the same as with the primary lesion - it all depends on the location of the tumor. Knowing them, it will be easier to prevent the recurrence of pathology. They are:

Bleeding of a strange nature;
Developing swelling of the extremities;
Enlarged lymph nodes, their pain;
The appearance of compactions on any part of the body;
Constant pain;
Difficulty swallowing, disturbances in the functioning of the stomach;
Changes in birthmarks and moles;
Constant fatigue and weakness;
Cough or hoarseness.

Moreover, there are no special signs of cancer relapse. It is easier to prevent the recurrence of a tumor by undergoing a timely medical examination and testing for the presence of cancer cells. This is done using CT and PET scans, radiography and blood tests.

Types of cancer

Among cancers, each type has its own rate of recurrence. In skin cancer, squamous cell carcinoma often develops again. Among the types of soft tissue cancers, liposarcoma and fibrosarcoma mainly return. Bone cancer reappears from metastases that spread from the primary tumor along the bone marrow canal. These pathological cells grow into the soft tissues of the body due to incomplete elimination of the consequences of oncology during surgery. Recurrence of breast cancer is characterized by the appearance of lumps and nodules in the area where the operation was performed.

Moreover, each type has its own characteristic signs of relapse of pathology:

Breast cancer is accompanied by redness and itching of the skin. The shape of the breast changes, and discharge with blood or pus may appear from the nipple.

Lung cancer upon return is characterized by signs of congestive pneumonia, persistent cough and the presence of blood in the sputum. The patient's breathing is heavy and wheezing.

Recurrence of skin cancer depends on the type of primary tumor. Nodules and plaques appear on the skin. Unexpected redness and bleeding occur.

Gastric cancer that occurs after partial resection indicates insufficient surgical intervention. Characterized by disorders, abdominal pain, frequent vomiting.

Brain cancer is a rather dangerous pathology, and when it recurs, the tumor develops in a limited space of brain tissue. Main manifestations: Headache, nausea and vomiting. In this case, visual impairment occurs, and intracranial pressure increases.

Liver cancer is practically incurable, and its repeated manifestation is metastases to the brain tissue, intestines and lungs. Characteristic symptoms are chronic fatigue, weight loss, pain on the right side under the ribs and fever.

Treatment for cancer recurrence

Recurrence of tumors should be treated taking into account its type and characteristics. Therapy usually consists of:

Surgical intervention - if the tumor has not had time to penetrate other tissues. Cancer cells are removed from the body;
Radiation therapy is effective in cases where it is necessary to stop the growth of a second tumor. It is used mainly as a method of additional treatment to the course of main therapy. Effective if surgery is impossible and the tumor metastasizes;
Chemotherapy - the course of drugs may be different from those used in the treatment of the primary tumor. If the cancer reappears within 2 years, it will be resistant to the same drugs. Prevents the tumor from affecting other tissues. This method is good because it is systemic, and therefore the pathology can be overcome if the tumor is localized in any part of the body;
Radiofrequency ablation, hormonal injections, cryodestruction - the use of methods depends on the type of cancer.
A course of immunotherapy and targeted treatment;
Palliative treatment.

Prevention

To prevent cancer from overtaking you again, follow these recommendations after removing the primary tumor:

Switch to healthy eating and diet. Include more vegetables and fruits in your diet, and give up processed foods, fast foods and fatty foods.

Lead not only a healthy, but also an active lifestyle - physical activity stimulates the tone of a person’s vital forces, but you should not be overzealous. To avoid additional problems in the body, you should know when to stop.

Consult your doctor - perhaps a course of vitamin therapy or the use of nutritional supplements will not be superfluous.

Be periodically examined by a doctor and get tested after the cancer is eliminated. In addition to this, it is worth mentioning that deviations from the doctor’s testimony after therapy usually do not lead to anything good

Take care of yourself and remember - a disease such as cancer recurrence does not have a specific drug that cures it.

Relapse I Relapse

diseases (lat. recidivus returning, renewing) - resumption, return of clinical manifestations of the disease after their temporary disappearance.

The occurrence of R. is always associated with incomplete elimination of the causes of the disease during its treatment, which, under certain unfavorable conditions, leads to the re-development of pathological processes characteristic of the disease and a corresponding resumption of its clinical manifestations.

Designating the course of the disease as recurrent necessarily presupposes the presence of periods of remission between periods of return of the disease, the duration of which ranges from several days (in infectious diseases) to several months, and in some cases (more often in non-infectious diseases) even up to several years. The duration of remission and the likelihood of R.'s occurrence are largely determined by the degree of compensation for the functional insufficiency of various systems that remained after incomplete recovery or was genetically determined, as well as the influence of the environment. If the activity of various body systems is not fully restored, R.'s occurrence is possible under normal conditions, but in some cases only extreme conditions can lead to R.'s disease.

Some forms of arthritis and peptic ulcers are prone to R.; It is customary to talk about the recurrent course of chronic bronchitis, chronic pancreatitis, and recurrent (recurrent) forms of schizophrenia. A recurrent course is characteristic of a number of diseases of the blood system, such as acute, pernicious anemia (see Anemia), etc. For some diseases, the occurrence of R. is so typical that it is reflected in their name, for example, recurrent.

The clinical picture of R.'s disease in comparison with its first manifestations can vary significantly both in the severity of symptoms and in qualitative terms. For example, rheumatism that occurs for the first time can occur in the form of chorea, and subsequent rheumatism can occur in the form of polyarthritis, rheumatic carditis, etc. In severe rheumatism, symptoms of complications, such as heart failure, can dominate, dramatically changing the clinical picture of the underlying pathology.

In some recurrent infectious and non-infectious diseases, the course and characteristics of R. are taken into account when establishing their diagnosis and carrying out differential diagnosis (typicality of symptoms during relapses of malaria, gout, seasonality of relapses of duodenal ulcer, etc.). Sometimes the vagueness, atypicality, or age of the primary manifestations of the disease can lead to incorrect interpretation of R. as the onset of the disease. Therefore, in diseases prone to relapsing, the basis for diagnosing R. is always a thorough history, sometimes with a critical reassessment of diagnoses of previously suffered diseases based on a retrospective analysis of their symptoms and course (see Diagnosis, Diagnostics).

Treatment of R.'s disease is determined by the nature of the underlying pathology, the presence of functional disorders acquired throughout the course of the disease, as well as complications accompanying this relapse. the earlier R. is started, the easier it is to achieve, therefore, in cases of a disease with a recurrent course, the patient should be informed about the possibility of R.'s occurrence and the need for timely consultation with a doctor.

Prevention of R. occupies an important place in the system of secondary prevention of diseases (see Prevention). It begins with full-fledged therapy of the first acute phase of the disease, which in some cases makes it possible to achieve complete recovery and prevent the transition of the pathological process to a chronic form, and in others it contributes to the maximum preservation or the most complete compensation of functions impaired by the disease, which reduces the likelihood of R. In many In cases, a significant role in the prevention of R. is played by measures for the rehabilitation of the patient after the acute phase of the disease, carried out taking into account the form and nature of the pathology, as well as the individual characteristics of the body, lifestyle and habits of the patient (see Rehabilitation). General health activities are of great importance, incl. rational, physical education, proper employment, elimination of bad habits. In case of infectious and allergic pathology, preventive measures are taken to promote the formation of immunity: various forms of stimulating therapy, in some cases the use of vaccines, gamma globulins, and the prescription of hyposensitizing agents.

For diseases that are prone to recurrence at certain times of the year, seasonal relapse is carried out. In our country, for example, prevention of R. rheumatism is carried out in the spring and autumn (use of bicillin, anti-inflammatory drugs). If seasonal peptic ulcers are worn, then in 2-3 weeks. Before the expected onset of R., the patient is recommended to take alkaline mineral waters, belladonna preparations, vitamin preparations, etc. more strictly than during the period of remission. Such preventive measures prevent the development of R. or significantly reduce the degree of its clinical manifestations.

The possibility of preventing R. and reducing their severity with timely treatment necessitates clinical observation of patients with recurrent forms of the disease (see Medical examination).

Relapse of infectious diseases. In infectious diseases, the occurrence of R. is due to the persistence of the pathogen in the patient’s body after the initial infection. In this way, R. differs from reinfection - recurrence of the disease due to re-infection, which is observed mainly in infectious diseases, as a result of which a person does not develop stable immunity. Various individual immunity disorders, congenital or acquired, and a decrease in the body's resistance can cause both reinfection and the transition of an infectious disease into a chronic form or the occurrence of an infectious allergy with the development of various forms of chronic pathology, characterized by a relapsing course. Complex clinical and immunological studies of cellular and humoral immunity in infectious patients show that the possibility of developing R. increases in cases where low titers of antibodies are observed during the period of the underlying disease, which is associated with inhibition of their formation. This makes it necessary to use treatment methods that would actively influence. However, there is evidence that an artificial increase in antigenic stimulation, although manifested by an increase in antibody titer, does not always prevent the development of relapse. On the other hand, an increase in the phagocytic activity of leukocytes in infectious diseases has a prognostically favorable value. A certain role in the occurrence of R. can be played by the L-form of the pathogen with the restoration of its virulence (, erysipelas,).

The development of R. is facilitated by late treatment, inadequate treatment, violation of the regime and diet, concomitant diseases, exo- and endogenous nutritional disorders, helminthiases and other factors. In some cases, for example, with typhoid-paratyphoid diseases, the number and frequency of R. increase with the use of antibiotics. The reasons for this may be early (unreasonable) withdrawal of the drug, as well as suppression of the body’s immune reactions by antibiotics. When antibiotics are used, R. usually occurs at a later date.

Relapses in infectious diseases are distinguished by frequency and timing of occurrence. Some infections are characterized by a single occurrence of R. (anicteric forms of leptospirosis), others - multiple times (erysipelas, abdominal). Early R. are characterized by the resumption of symptoms of the disease several days after the disappearance of the main manifestations of the disease; late R. (for example, with erysipelas, brucellosis) can occur in a very distant period.

Clinical manifestations of R. in infectious diseases are in many ways similar to the symptoms of the underlying disease. In most cases, R. occurs in a milder form than the primary manifestation of the disease, its duration is shorter, although sometimes a more severe and prolonged course is observed. With R., there may be individual symptoms characteristic of a given infectious disease, and in some cases it manifests itself in a different clinical form (for example, R. after the gastrointestinal form of salmonellosis can occur in the form of its septic form).

Treatment of patients with a recurrent course of an infectious disease should consist of the complex use of antibiotics, vaccines, and other stimulants of immunogenesis. In addition, it is necessary to exclude provoking factors, as well as prescribe antihistamines and nonspecific drugs that increase the body's resistance to the infectious agent.

Relapse. In relation to R. tumors, unified terminological assessments have not yet been achieved. A distinction is made between relapse of cancer in and R. tumors at the site of a former neoplasm some time after radical surgery, radiation, or other treatment. Local R. can be the result of the growth of multicentric tumor primordia, micrometastases, or the continued growth of a neoplasm during its non-radical removal. In some types of neoplasms (lymphogranulomatosis, chorionepithelioma, seminoma, etc.), when long-term treatment is possible as a result of combination or conservative therapy, the resumption of the disease is interpreted as P. The development of metastases at various times after healing of the primary tumor is designated as disease progression. In this case, it is localized outside the operation area or radiation fields in distant lymph nodes and parenchymal organs (lungs, kidneys, etc.) or manifests itself in the form of tumor dissemination along the serous membranes.

A distinction is made between early R., which occurs during the first months, and late R., which occurs after 2-3 years or more. R. can be caused by tumor cells and their complexes located outside the remote part of the organ and irradiation fields, micrometastases in partially preserved regional lymph nodes, tumor cells during mobilization and damage to the tumor during surgery, individual cells and their populations during radiation therapy, primary multiplicity the germ of tumors in one organ.

Local R. tumors can be single or multiple, localized directly in the scar or anastomosis, at the site of a former tumor or in the area of the surgical field, and occur repeatedly.

The frequency and nature of R. tumors depend on the histological form of the tumor, the radicality of the treatment, the primary localization of the tumor, its stage, the nature of growth, the degree of differentiation of tumor cells, and the state of the patient’s body’s defenses.

After removal of benign tumors, R. are rare; their occurrence is associated with non-radical surgery or multicentricity of tumor primordia (breast, gastric mucosa, colon).

Malignant tumors have a particular recurrence rate. Among skin tumors, basal cell carcinomas and squamous cell carcinomas are prone to R., and among soft tissue tumors, R. fibrosarcomas and liposarcomas are often observed. R. of malignant bone tumors (for example, chondrosarcoma) appear during insufficiently radical operations due to the germination of tumors into soft tissues and the spread of the process along the bone marrow canal. Local R. of breast cancer arise in the form of single and multiple nodes in the area of the former operation. R. tumors of the gastrointestinal tract, such as cancer of the stomach or rectum, are more common in cases where it was produced within the tumor tissue.

During the first two years after treatment, it can be difficult to establish the true cause of progression of the tumor process (relapse or metastasis). In these cases, a recurrence, regardless of the location of occurrence, is often regarded as a relapse.

Treatment of R. malignant tumors is often conservative with the use of radiation therapy and antitumor drugs, which is mostly effective. Surgical or combined treatment of relapses is also possible.

Prevention of R. tumors consists of both early diagnosis and timely surgical treatment for locally limited tumors, and maximum adherence to the principles of ablastics.

Cancer patients are important for the timely detection of R. tumors and rational treatment. Its role is especially great in cases where it is possible to predict the development of a relapse (for example, with liposarcoma) or the progression of the disease during the first years after radical treatment.

Bibliography: Blokhin N.N., Klimenkov A.A. and Plotnikov V.I. Relapses of stomach cancer, M., 1981; Vasilenko V.X. and Grebenev A.L. Diseases of the stomach and duodenum, p. 171, M., 1981; Dukhov L.G. and Vorokhov A.I. Diagnostic and treatment-tactical errors in pulmonology, p. 214, M., 1988; Immunological aspects of infectious diseases, ed. J. Dick, . from English, p. 14, 469, M., 1982; General human, ed. A.I. Strukova et al., p. 443, M., 1982; Guide to Hematology, ed. A.I. Vorobyova, vol. 1, p. 234, M., 1985; Guide to Infectious Diseases, ed. IN AND. Pokrovsky and K.M. Lobana. M., 1986.

II Relapse (recidivum; lat. recidivus returning, renewing; from recido return)

reappearance of signs of the disease after remission.

Synonyms:

See what “Relapse” is in other dictionaries:

- (Latin, from recidere to return, to renew). 1) return of the disease. 2) repetition of the same crime for which there was a conviction. 3) generally returning to something. Dictionary of foreign words included in the Russian language. Chudinov A.N.,... ... Dictionary of foreign words of the Russian language

RECURRENCE, relapse, husband. (lat. recidivus returning). 1. Resumption, return, repetition of something (usually unwanted). Relapse of illiteracy. 2. A new manifestation of the disease after its apparent or incomplete cessation (med.).... ... Ushakov's Explanatory Dictionary

relapse- a, m. recidive f., German. Rezidiv lat. recidivus returning. 1. Recurrence of the disease after an apparent complete recovery. ALS 1. Relapse or recurrence, return of an attack of the disease, a secondary attack, relapse into a past disease, regurgitation of the disease... Historical Dictionary of Gallicisms of the Russian Language

Cm … Synonym dictionary

RECIDENT- (from Latin recidivus returning) return of the disease, i.e. its repetition in a typical form immediately after recovery or during the recovery period. As a rule, however, R. emerges as an exact repetition of the former; it usually runs shorter and... Great Medical Encyclopedia

Relapse- see Recidivism... Encyclopedia of Law

Relapse(lat. recidivus recurrent) - return of symptoms of the disease after apparent recovery or temporary improvement. The periods between relapses, when the symptoms of the disease temporarily disappear, are called remissions. The cause of relapses is incomplete recovery, the persistence of the action of pathogenic factors - exogenous and endogenous (genetic characteristics of the body, insufficiency of acquired immunity, etc.).

Many diseases are characterized by a chronic relapsing course. These include peptic ulcer, rheumatism, gout, chronic bronchitis, bronchial asthma, chronic pyelonephritis, chronic hepatitis, etc. Many infectious diseases have a recurrent course, for example, relapsing fever, brucellosis, malaria, typhoid fever, syphilis. The duration of remissions can vary from several days (for example, with malaria) to several months and years (for example, with peptic ulcers, rheumatism, syphilis). The clinical picture of a relapse may completely or partially correspond to the initial picture of the disease (for example, with gout) or differ significantly from it (for example, with syphilis). Treatment of relapse basically corresponds to the treatment of the disease at its initial manifestation.

In the prevention of relapses, early, complete treatment in terms of drug dosages and duration in the acute phase of the disease is of primary importance. For chronic diseases prone to relapsing, patients are subject to dispensary observation. During periods of the most likely occurrence of relapse, preventive anti-relapse treatment is carried out (for example, seasonal prevention of rheumatism, peptic ulcer).

Relapse is characteristic not only of infectious diseases

By the way, for some ailments such a course is so typical that it is even included in their name: relapsing fever, recurrent paralysis, etc.

The essence of relapse

Reasons for relapse

The risk of the disease returning depends on many factors. The most common reasons for relapse are:

The causes and characteristics of relapses can be most clearly examined using the example of diseases caused by malignant neoplasms.

Types of cancer recurrence

Different types of cancer recurrence are not always asymptomatic - patients notice the appearance of a new nodule in an unusual place or the manifestation of familiar signs. And relatives can pay attention to the patient’s emerging anemia, weakness and causeless depression - naturally, all this requires an unscheduled visit to an oncologist and the beginning of a new stage of treatment.

What types of cancer have frequent recurrences?

And in breast cancer, relapse manifests itself in the form of single or multiple nodes in the previously operated area.

The possibility of relapse is difficult to establish

What signs determine the possibility of relapse?

Localization of the tumor. For example, skin cancer (especially at stage 1 of the disease) has an almost 100% positive outcome, and recurrence of cancer of the inner quadrant of the breast is more likely than if the tumor is located in the outer quadrant, etc.
The structure of the neoplasm and the form of tumor growth. Thus, in skin cancer, the superficial form of the tumor grows very slowly and does not metastasize for many years. And for lung cancer, the worst prognosis is observed for its poorly differentiated form.
Nature and extent of treatment provided. The most favorable results are obtained by a combination therapy method.
Age of patients. At a young age, metastasis occurs faster and is more severe than in older people.

As you can see, a relapse is a combination of many factors that lead to the resumption of the disease. This means that observation by a doctor and timely detection of signs of relapse will help ease its course, and in some cases, prevent the onset of the disease process.

Cancer relapse is an unhealthy condition of the human body, which is characterized by the re-formation of a malignant tumor after completion of a course of chemotherapy. Surgery and ionizing radiation can also cause cancer to recur. Secondary formation of an oncological focus occurs due to surviving cancer cells due to unsuccessful antitumor treatment.

Relapse in oncology indicates improper treatment. Equally, the rapid formation of a malignant tumor from many foci of maturation can cause a repeated manifestation. Certain types of cancer are not affected by radiation chemotherapy, so the therapy only stops the mutation of the affected cells.

Features of recurrence of external cancer are established by visual examination of the affected area. Secondary cancer of internal organs is diagnosed by endoscopic, x-ray, ultrasound, and magnetic resonance imaging.

Signs of tumor recurrence

The formation of an atypical node is abnormal skin compaction in the area where surgery was previously performed to remove the tumor.
Pain syndrome that occurs in intense attacks.
Enlarged lymph nodes, with possible pain.
Swelling of the upper and lower extremities.
Restoring the functionality of cells that are affected by cancer is possible with a suitable site for the root cancer movement.

Symptoms of recurrent breast cancer

The secondary formation of a malignant neoplasm on the mammary glands is characterized by itching and redness of the skin, hardening and change in the shape of the breast, bloody or purulent discharge from the nipple.

Symptoms of prostate cancer recurrence

The secondary appearance of a prostate tumor is diagnosed by rectal examination. This relapse is characterized by transfer of the disease focus to distant organs. In laboratory conditions, recurrent cancer is diagnosed and detected due to the waste products of the neoplasm. Dynamic changes in tumor marker criteria indicate the type of malignant process.

Symptoms of recurrent lung cancer

Local formation of an oncological focus in the lungs is indicated by congestive pneumonia, chronic cough, bloody sputum and severe wheezing.

Symptoms of liver cancer recurrence

Malignant liver tumors can be cured, but you need to be prepared for a long treatment process. The life expectancy of patients is no more than six months. For this reason, relapse of liver cancer is usually perceived as a distant focus of the pathological cycle in the chest or intestinal and brain tissues. The destructive process is rapidly developing and increasing in the body. Signs of liver cancer recurrence include:

weight loss;
constant fatigue;
severe pain in the right hypochondrium;
increased body temperature;
liver growth.

Symptoms of brain cancer recurrence

The characteristics of the secondary appearance of a tumor in brain tissue are determined by the restoration of a malignant neoplasm in a limited space. The main symptoms of reappearance include:

nausea;
frequent attacks of headaches;
constant vomiting;
blurred vision;
intracranial pressure;
deterioration in the functioning of sensory organs.

Symptoms of recurrent skin carcinoma

The signs of a secondary skin neoplasm are modified accordingly to the type of rope malignant process. Plaques, ulcers, and nodules indicate squamous and basal cell formations. Many bleeding ulcers may form on the affected area, around which there is redness of the skin. Melanoma is practically not subject to recurrence, which is characterized by the formation of multiple sources on various organs.

Symptoms of recurrent ovarian carcinoma

Malignant ovarian tumors have an increased risk of secondary recurrence. As a rule, to avoid recurrence of cancer, the patient's genital appendages are removed. Repeated ovarian cancer is expressed by a decrease in the volume of urine that is released over a certain amount of time, upset of the digestive tract, and pain in the lower abdomen.

Symptoms of recurrent stomach cancer

Recurrence of gastric carcinoma is accompanied by constant vomiting and acute pain in the area of the digestive cavity.

Symptoms of recurrent uterine carcinoma

Upon completion of the treatment, the formation of purulent discharge from the external genitalia is allowed, which indicates a malignant lesion of the uterus.