With the return of cancer once again, Hall of Fame quarterback Jim Kelly confronts a potentially challenging medical path ahead of him.
But with the limited specifics available about his latest diagnosis, it is difficult to know what his treatment or prognosis might be.
Experts say that among the issues that will likely be assessed by Kelly and his medical team include whether a tumor is in the same area as before or in a new location, the stage of the tumor, whether it can be surgically removed, what other therapies remain options for treatment, the potential complications of treatments and what is the patient's overall physical health.
"It's unfortunate when there is a cancer recurrence, but it is not necessarily terminal," said Dr. Wesley Hicks Jr., chairman of the department of head and neck/plastic and reconstructive surgery at Roswell Park Comprehensive Cancer Center.
"All cancer is a challenge, whether it is the first diagnosis or a recurrence. And the recurrence isn't necessarily more challenging. You have to consider all the factors involved in each case," he said.
One positive sign, for instance, is that Kelly has gone four years since his last recurrence in 2014.
The former Buffalo Bills quarterback issued a statement Thursday announcing that his cancer had returned.
"As our family has faced many trials and triumphs throughout the years, you have blessed us with your prayers. We are asking for those prayers once again," he announced.
"The oral cancer we hoped would be gone forever has returned. Although I was shocked and deeply saddened to receive this news, I know that God is with me. I continuously talk about the four F's: Faith, Family, Friends and Fans. With all of you by my side, we will fight and win this battle together. Staying “Kelly Tough” and trusting God will carry us through this difficult time."
News of the recurrence comes shortly before Kelly is to be honored Saturday in Milwaukee by the Vince Lombardi Cancer Foundation at its 28th Award of Excellence Dinner Ball. The foundation raises funds to support cancer research, prevention and care. Kelly is scheduled to speak at the event.
In an Instagram post, Kelly's wife, Jill, wrote, "The cancer is back. We are shocked, heartbroken, sad, angry, confused and just darn tired."
Kelly, 58, was diagnosed with squamous cell carcinoma isolated to his upper jaw in June 2013. Doctors at Erie County Medical Center removed part of the upper jaw, part of the roof of his mouth and numerous teeth.
"The ECMC family sends its affection and thoughts to Jim Kelly and his family. He has always shown ECMC and our entire community what it means to be "Kelly Tough," and we will all be at his side as he shows us again," hospital officials said in a statement.
In March 2014, Kelly's cancer came back, having spread to his maxillary sinus cavity and adjacent tissues. After radiation and chemotherapy, Kelly announced in August that year that he was once again cancer-free.
Cancers of the oral cavity may involve bone, teeth, muscle, nerves, blood vessels, saliva glands, and the specialized lining called mucosa. By far, the most common cancer of the oral cavity is squamous cell carcinoma, and it arises from the lining of the inside the mouth, the nose, and the throat, according to the National Cancer Institute.
In recurrent oral cancer, doctors generally will put all the treatment options on the table, although radiation might be excluded if it was used in the past, depending on the circumstances, Hicks said.
Citing the progress in treatment and survival he has witnessed during his career, Hicks stressed that it's important to maintain an attitude of hope and optimism. That's especially true for distraught patients and their families when cancer comes back.
"The first goal is a cure with quality of life," he said. "I feel there is always something that can be done."
Tobacco use is the main risk factor for oral cancers. Kelly was not a smoker or tobacco chewer.
“Luck of the draw,” he said in a 2013 interview when first diagnosed with cancer. “Bad luck. I don’t know what you want to call it."
News Sports Reporters Jay Skurski and Vic Carucci contributed to this story.