A study looking at symptoms that could be caused by cancer coming back after treatment

Cancer type:

Bowel (colorectal) cancer
Breast cancer
Prostate cancer





This study looked at people who had previously had cancer and the sort of symptoms that made them go to see their family doctor (GP).

More about this trial

People have follow up appointments with their specialist doctor after treatment for cancer of the:

But after a few years, if they remain well, these appointments may stop. After that, they are encouraged to go to their GP if they have any new symptoms, or if they are worried about anything.

New symptoms may be caused by the cancer coming back or spreading somewhere else in the body (a recurrence Open a glossary item). But they could also be caused by something else.

In this study, the researchers looked back at the medical notes of people who had symptoms some time after treatment for cancer. They looked at the medical notes of people whose cancer had come back as well as people whose symptoms were caused by something else. They also included some people who didn’t have cancer in the analysis. Researchers call them the control group. The GP practices that took part were based in Devon.

The aim of the study was to look for common symptoms of cancer recurrence.

The researchers hoped this could help GPs in the future to spot the signs that cancer may have come back.

Summary of results

The study team found that being sick, shoulder pain, low back pain and loss of appetite were common symptoms in people whose cancer had spread. But these symptoms were also present in people with a previous cancer who didn’t have any cancer spread and in the healthy control group.

In this small study, the team looked at symptoms reported in the GP medical records of:

  • 162 people who had breast, prostate or bowel cancer and whose cancer had come back elsewhere in the body (metastasised)
  • 152 people who had the same type of cancer and whose cancer hadn’t come back
  • 145 healthy controls

In the year before people had their cancer recurrence diagnosed, researchers looked at signs, symptoms and blood test results.

In this study, the researchers found:

  • being sick
  • shoulder pain
  • low back pain
  • loss of appetite

were common in people whose cancer had spread. But these were also common in people with a previous cancer whose cancer hadn’t come back. So the researchers say there is a moderate link with the above symptoms and cancer recurrence.

The researchers also found that groin pain and lung problems were less common symptoms but had a stronger link with cancer spread. The lung problems included a collection of fluid in the lungs (pleural effusion) or inflammation of the lining of the lung (pleurisy).

The researchers found that:

  • 16 people with cancer spread had groin pain compared with 1 cancer control and 5 healthy controls
  • 9 people with cancer spread had a pleural effusion or pleurisy compared with 1 cancer control and 1 healthy control

From the above, the researchers say these symptoms were strongly linked with having cancer recurrence. Having an abnormal liver function test Open a glossary item was also linked with having a cancer recurrence if the person was also being sick 3 months before diagnosis.

As this study only looked at 3 cancers, it is impossible to know whether the same symptoms would be present across all cancers. It was a small study so it was also quite hard to draw firm conclusions.

Specific symptoms of cancer recurrence such as pain were quite scarce and non specific symptoms such as being sick or loss of appetite were more common. Nevertheless being sick, loss of appetite and low back pain need further testing in people who have been diagnosed with a previous cancer.

The researchers say these non specific symptoms can make diagnosis more complicated. They concluded that the above can help explain the long time it takes to diagnose cancer spread.

We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Dr Peter Rose

Supported by

NIHR Clinical Research Network: Cancer
University of Oxford

If you have questions about the trial please contact our cancer information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:


Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Last reviewed:

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