What is remission of cancer

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Understanding Cancer Remission: Definitions, Mechanisms, and Clinical Implications

Definition of Cancer Remission

Cancer remission refers to the reduction or disappearance of the signs and symptoms of cancer. It can be classified into two main types: complete remission and partial remission. In complete remission, all signs and symptoms of cancer are gone, while in partial remission, the cancer has shrunk but has not completely disappeared .

Spontaneous Remission of Cancer

Spontaneous remission is a rare phenomenon where cancer regresses without any medical treatment or with treatment that is not expected to cause such a significant effect. This can occur in both solid tumors and hematologic cancers like leukemia . For instance, a case study reported a 61-year-old man with metastatic non-small-cell lung cancer (NSCLC) who experienced complete spontaneous remission of his abdominal wall, liver, and lung metastases. Another case involved a 4-year-old girl with acute lymphoblastic leukemia who experienced spontaneous remission of her mediastinal mass and leukemic findings.

Factors Influencing Remission

Several factors can influence the likelihood of achieving remission, whether spontaneous or treatment-induced. These include:

Immune Response: The body's immune system can sometimes mount a response strong enough to eliminate cancer cells. For example, high-dose radiation has been shown to transform the tumor microenvironment, leading to an intense infiltration of CD8+ T-cells and a reduction in myeloid-derived suppressor cells, which can mediate durable remissions.
Tumor Characteristics: The size and number of metastases, as well as the tumor's immunogenicity, can affect remission outcomes. Smaller primary tumors and fewer metastases are associated with better prognosis and higher chances of remission.
Treatment Modalities: The combination of chemotherapy, radiation, and surgery can significantly impact remission rates. For instance, in advanced NSCLC, long-term survivors often received multiple lines of chemotherapy along with radiation or surgery to control primary and oligometastatic tumors.

Psychological and Social Aspects of Remission

Cancer remission is not only a physical milestone but also has significant psychological and social implications. Patients in remission often experience a mix of positive and negative emotions, including relief, hope, anxiety, and fear of recurrence. The loss of social support and the need for self-perseverance are also common attributes during remission.

Conclusion

Cancer remission, whether spontaneous or treatment-induced, is a complex and multifaceted phenomenon influenced by various biological, psychological, and social factors. Understanding these factors can help improve patient care and communication between healthcare providers and cancer survivors, ultimately enhancing the overall well-being of those in remission.