What is cancer remission
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Understanding Cancer Remission
Definition of Cancer Remission
Cancer remission refers to a state where the signs and symptoms of cancer are reduced or disappear. This can be categorized into complete remission, where all signs of cancer are gone, and partial remission, where the cancer has shrunk but not completely disappeared. Remission can be temporary or permanent, and it is a critical milestone in cancer treatment and survivorship.
Concept Analysis of Remission in Cancer Survivorship
A comprehensive analysis of remission within cancer survivorship highlights that remission is often accompanied by a mix of physical and psychological symptoms. Patients in remission may experience anxiety, fear of recurrence, and a need for self-perseverance. Despite being free of measurable disease, the journey through remission includes both positive outcomes, such as hope and appreciation for life, and negative outcomes, such as persistent anxiety and loss of social support.
Spontaneous Remission of Cancer
Definition and Rarity
Spontaneous remission (SR) is an extraordinary phenomenon where cancer regresses without any medical treatment or with treatment that is inadequate to cause such regression. This rare event is more frequently documented in certain cancers, such as non-small-cell lung cancer (NSCLC), but remains extremely uncommon overall .
Case Studies and Mechanisms
Several case studies have documented instances of spontaneous remission in lung cancer. For example, a 61-year-old man with metastatic NSCLC experienced complete remission of abdominal wall metastases and later, liver and lung metastases, without any active treatment. This remission persisted for over five years. Another case involved a 68-year-old man with poorly differentiated pulmonary adenocarcinoma who underwent a durable complete SR without any active therapy.
The biological mechanisms behind SR are not fully understood, but immune responses are often implicated. In one case, strong anti-NY-ESO-1 immunity was detected in a patient with NSCLC, suggesting that the immune system played a significant role in the spontaneous regression of the tumor. Additionally, the presence of numerous inflammatory cells around and inside resected tumors in long-term survivors indicates a robust immune response.
Clinical Features and Treatment Modalities for Achieving Remission
In advanced stages of NSCLC, achieving complete remission is rare but possible with a combination of treatments. Long-term survivors often undergo multiple lines of chemotherapy, radiation, and surgery to control primary and oligometastatic tumors. The presence of smaller primary tumors and fewer metastases are independent prognostic factors for achieving remission. Strong immune responses, as evidenced by the presence of inflammatory cells, are also crucial in these cases.
Conclusion
Cancer remission, whether achieved through medical intervention or spontaneously, represents a significant milestone in the journey of cancer survivorship. While spontaneous remission remains a rare and poorly understood phenomenon, it underscores the potential of the immune system in combating cancer. Continued research and improved communication between healthcare providers and patients are essential to enhance the understanding and management of remission in cancer care.
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