Remission in cancer is a fundamental concept that represents a ray of hope for patients and their families. This term refers to the decrease or disappearance of the signs and symptoms of cancer, marking a significant milestone in the treatment of the disease.
Understanding what remission means, its different types and what it means for the patient is fundamental for those on the road to recovery. This article aims to clarify these aspects so that patients and their families can navigate this process with greater confidence and knowledge.
What is remission in cancer?
In oncology, remission refers to the reduction or disappearance of the signs and symptoms of cancer. It is important to distinguish between the reduction of symptoms and the total absence of cancer. Remission can be partial, where some signs and symptoms disappear, or complete, where no signs of cancer are detected in the body.
Difference between remission and cure
Although remission is a positive step, it is important to clarify that it does not always mean a cure. Complete remission indicates that there are no detectable signs of cancer, but the cancer cells may remain in the body and cause a recurrence. In medicine, it is preferable to use the term ‘complete remission’ rather than ‘cure’ because of the possibility of the cancer returning.
Types of remission
Partial remission
Partial remission means that the cancer has decreased significantly but has not completely disappeared. It is detected by imaging tests and other diagnostic methods and may involve adjustments to the treatment. It is common in certain types of cancer, such as lymphoma and some breast cancers.
Complete remission
Complete remission is defined as the total absence of signs and symptoms of cancer. Screening methods include imaging tests, blood tests and tumour markers. Although this is a significant achievement, there is a possibility that the cancer may return even after a complete remission.
Factors influencing cancer remission
Cancer remission can be influenced by a variety of factors, including the type and stage of the cancer, response to treatment and individual factors such as genetics, lifestyle choices and the immune system.
Importance of cancer type and stage at diagnosis
The type of cancer and its stage at diagnosis are key determinants of remission. The staging of cancer refers to the extent of the disease in the body, including the size of the tumour and whether it has spread to other parts of the body. Cancers in earlier stages tend to have better remission rates as they are easier to treat and control. For example, a cancer detected at stage I is more likely to go into complete remission compared to one at stage IV.
Response to treatment
The effectiveness of treatments such as chemotherapy, radiotherapy, immunotherapy and surgery plays a fundamental role in the remission of cancer. Response to treatment can vary significantly between patients, even those with the same type of cancer. Some treatments can reduce the size of the tumour or eliminate it completely, while others may not be as effective. The combination of different treatments can also improve the chances of remission
Individual factors: genetics, lifestyle and immune system
- Genetics: genetic predisposition can affect response to treatment and the likelihood of remission. Some people may have genetic mutations that make their cancer cells more resistant to certain treatments.
- Lifestyle: healthy habits such as a balanced diet, regular exercise and avoiding smoking and alcohol consumption can improve the response to treatment and reduce the risk of recurrence. In addition, a healthy lifestyle can strengthen the immune system, helping the body to fight cancer more effectively.
- Immune system: a strong immune system can help to control and eliminate cancer cells. Immunological therapies, which stimulate the immune system to attack the cancer, have shown promising results in the remission of certain types of cancer.
Follow-up and control after remission
Examinations and control tests
Physical examinations: regular physical examinations are an essential part of post-remission follow-up. During these visits, the doctor will assess the patient’s general state of health, look for signs of cancer recurrence and address any new or persistent symptoms. It is recommended that these check-ups take place every 3 to 4 months during the first 2 to 3 years after treatment, and then be spaced out to once or twice a year until the age of 5, becoming annual thereafter, depending on the type of tumour.
Blood tests: blood tests are important tools for monitoring the patient’s health and detecting early signs of recurrence. These may include:
- Complete blood count: to assess red blood cell, white blood cell and platelet levels.
- Liver and kidney function tests: to ensure that these organs are functioning properly.
- Tumour markers: substances that may be present in high levels if the cancer has returned, however, tumour markers can be elevated for other reasons such as impaired liver or kidney function, smoking… so their values should always be interpreted by a specialist.
Imaging tests
Imaging tests are crucial for visualising the inside of the body and detecting any abnormalities that may indicate a recurrence of the cancer. The most common tests include:
- X-rays: used to detect changes in the bones and lungs.
- Computed tomography (CT): provides detailed images of internal organs.
- Magnetic resonance imaging (MRI): used to obtain detailed images of soft tissue.
- Positron emission tomography (PET): helps to identify areas of abnormal metabolic activity that may indicate the presence of cancer.
Specific tests depending on the type of cancer
Depending on the type of cancer the patient has had, additional tests may be necessary. For example:
- Mammograms: for breast cancer patients.
- Colonoscopies: for those who have had colon cancer.
- Gastroscopy: for patients who have had oesophageal or stomach cancer
- Cervical ultrasound: for patients with thyroid, parathyroid and parotid gland cancer.
- Bone scintigraphy to assess bone metastases: for example, from breast or prostate cancer.
- CT and MRI of the brain to monitor brain metastases
- Cytology and HPV tests: for women who have had cervical cancer and for patients with anal cancer.
Monitoring for long-term side effects
Cancer treatment can cause side effects that appear months or even years after the end of treatment. These are known as late effects and include heart, lung, neurological, hormonal and fertility problems, among others. It is important that patients inform their doctors about any new or worrying symptoms so that they can receive appropriate care.
Emotional and psychological support
Medical follow-up should also include emotional and psychological support. Cancer survivors may experience anxiety, depression and other emotional problems such as cancer phobia or fear of a second cancer or recurrence of the primary or development of metastasis. Talking about these issues with a mental health professional can be very beneficial, such as our team of psycho-oncologists.
Lifestyle and prevention
Maintaining a healthy lifestyle is essential to reduce the risk of relapse. A balanced diet, regular exercise and avoiding harmful habits such as smoking and alcohol consumption are recommended. In addition, psychological and emotional support is vital for cancer survivors.
What to do if the cancer returns?
Cancer recurrence occurs when cancer cells that remained in the body after initial treatment start to grow again. This can happen in the same place where the cancer originated (local recurrence), in nearby lymph nodes (regional recurrence) or in a distant part of the body (distant recurrence or metastasis).
The impact of the news can be a very challenging experience for the patient. It is important to understand the available treatment options and to seek medical and psychological support. Treatments may include a combination of previously used therapies or new strategies based on available medical advances.
In short, remission in cancer is a crucial step on the road to recovery. In this sense, it is a term that indicates that we can maintain cautious optimism about the clinical situation. Although it does not always mean a cure, it offers hope and a better quality of life for patients. Proper medical follow-up and a healthy lifestyle are essential to maintain remission and prevent recurrence.
