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Survivors // July 5, 2017 MAAC Staff

What Is Cancer Remission?

“You’re in remission” is among the best news you can hear as a cancer patient. It makes the hard decisions, the challenges of treatment, and the mental exhaustion worth it. But that doesn’t mean the cancer journey ends there.

Cancer care generally isn’t black and white. For most patients, their journey will often not be as simple as receiving a diagnosis, getting treatment, and being “cured.” In the case of mesothelioma patients, with a typical prognosis of about a year to 21 months, it can be extremely difficult to treat the cancer in the first place because it’s often found in a late stage. There are very few long-term survivors, and even for them the fear of recurrence remains.

But even though being in remission isn’t as simple as being cancer-free forever, it’s still a big victory against cancer.

What It Means to be In Remission

In essence, remission is the absence of an active disease or cancer. Doctors use this term when the cancer has improved measurably, though it doesn’t necessarily mean the cancer is entirely gone. There are two types of remission patients should understand.

Complete remission means the oncologist sees no evidence of cancer when examining scans or performing a physical examination of the patient. There are no signs or symptoms indicating cancer’s presence. Complete remission can also be described by some doctors as “no evidence of disease” (NED) or “complete response.” However, health professionals note even with complete remission there can still be microscopic cancer cells present that current technology and techniques may not be able to identify.

Partial remission means a large percentage of the signs or symptoms of cancer are gone, but some still remain and are detectable. In most cases, oncologists consider partial remission to mean tumor size has decreased by 50% and has remained this smaller size for at least one month. Partial remission may also be referred to as “controlled” or “stable disease.”

Partial remission can certainly improve quality of life, since a patient is experiencing less symptoms from their disease. But, partial remission does not always mean a patient will live longer. With partial remission, there is a higher chance of disease progression, or the tumors growing in size again or even spreading.

While complete remission is considered better news than a partial remission because recurrence is less likely, it’s still not a guarantee that cancer won’t return.

Is Remission the Same as a Cure?

Unfortunately, there is no cure for cancer and doctors don’t even consider complete remission as the same scenario as being cured. In some cases, patients may be in remission for many years and still experience recurrence. This can often mean the cancer was present throughout that time, but was too small to detect.

On the other hand, with more time in remission, patients face a much lower risk of recurrence and some may think of them as being cured. But many doctors disagree with the certainty such a statement implies. Some cancers also have a higher risk of recurrence than others. Many mesothelioma patients, for example, sadly face a recurrence of the disease because of its aggressive nature. Even after intense treatment methods, it’s still difficult for many mesothelioma patients to beat the odds.

But some patients may get some insight around the odds of cancer recurring. Patients may hear their doctor discuss their remission rate, sometimes referred to as a cure rate. These remission rates are essentially estimates of how many patients will remain in remission in a certain time period.

For example, a doctor may say there is an 80% 5-year remission rate, which would imply that 80% of patients for that cancer will likely remain in remission for 5 years or more. This concept is along the same lines as survival rate, just specifically considering remission and giving insight into the chances of cancer recurrence.

The Importance of Ongoing Cancer Care

For any cancer patient, care doesn’t end when learning of a complete or partial remission. Even in survivorship, patients continue to receive medical follow-ups and closely monitor their health.

Periodic exams and imaging scans are essential for proactively finding any signs of recurrence or the development of a different type of cancer early on. This monitoring is also beneficial for any late or long-term side effects a patient may be experience from the cancer itself or their treatment.

For those in partial remission, sometimes doctors look to manage the cancer as a chronic disease. While the cancer doesn’t progress or change, they decide on treatments to keep the cancer “controlled” and more stable, as well as alleviating symptoms and attempting to help the patient live longer.

While remission is not necessarily the same as a cure, for many patients it can mean the start of survivorship. And even if the cancer does return, a patient in remission can be a beautiful source of hope and a small relief from fighting. Even with no guarantees, that hope is a wonderful thing.