Remission is the reduction in or disappearance of cancerous tumors and cancer symptoms. It can be partial or complete, and complete remission is often considered to effectively be a cure. Because mesothelioma is so difficult to treat and is considered incurable, achieving even partial remission for patients is considered a success. In rare cases, mesothelioma may actually disappear completely and a patient may experience complete remission. Achieving any level of remission usually requires multimodal therapy, but there have been very rare cases of spontaneous remission.
In discussions of any kind of cancer, including mesothelioma, there are two types of remission: partial and complete. Partial remission refers to a significant improvement in cancer in a patient, but not a complete disappearance of disease. Someone treated for mesothelioma that experiences partial remission will probably see a big improvement in symptoms and will feel much better. The medical team will be able to see sizable reductions—although not complete— in the tumors and the presence of markers for cancer cells in the body.
Mesothelioma, both pleural and peritoneal, is difficult to treat. This is especially true because most patients receive a diagnosis and start treatment after the disease has developed past stage I. For many patients the goals of treatment are simply palliative, to help them feel better and to give them an improved quality of life. However, for others there is hope that a combination of treatments as well as the use of emerging treatments or clinical trials could help them achieve partial remission. Partial remission not only means feeling better, but also extending a patient’s life.
In cancer terms, complete remission means that all symptoms are gone and that all signs of cancer in the body have disappeared. Complete remission is rare in patients with mesothelioma because of how aggressively and rapidly it spreads in the body. It is very difficult to eliminate every tumor and every cancer cell for a patient with mesothelioma. It is rare, but it does happen every once in a while. When a patient does achieve complete remission, it may feel like being cured of cancer, but it is no guarantee that the cancer will never return again. This is because although the medical team can no longer detect cancer cells, there may still be some in the body at the microscopic level after treatments.
The Difficulty with “Curing” Mesothelioma
A lot of people refer to complete remission as a cure. With mesothelioma this can be tricky. It is considered an incurable cancer, but rarely people do experience remission. Even for these people, though, it is likely that the cancer will return at some point. It can be difficult to understand why remission or curing mesothelioma is so tough, especially when compared to other cancers.
The reasons are not fully understood, but researchers and experts in mesothelioma do know that it spreads quickly and aggressively. The greater the tendency of a cancer to spread to other tissues, organs, and distant parts of the body, the more difficult it is to control, and ultimately to cure. Another reason mesothelioma is difficult to cure is that it is most often diagnosed when it has progressed past early stages. If mesothelioma can be caught in stage I, the chances of remission are much greater.
Among all the stories of people who do not survive a mesothelioma diagnosis, there are amazing stories of remission. One such story was written up in a journal in 2007 and described a 61-year-old woman who was diagnosed with mesothelioma and went into spontaneous remission. Six months after the diagnosis, she was disease free and she was still cancer-free five years after that. The woman was given treatment options, but felt well and declined any treatment. Over several screenings months later, her doctors watched her tumors shrink and disappear. No one understands how such spontaneous remission can occur.
Another case of remission of mesothelioma occurred in a 71-year-old Japanese patient diagnosed with peritoneal mesothelioma. She underwent surgery and a course of chemotherapy and 223 days after the initial surgery, she was cancer-free and had gone into complete remission. Unfortunately, though, the remission did not last and she experienced a recurrence in the pleura about eight months later.
Recurrence after Remission
For patients who experience remission, it is important to be aware that recurrence is always possible. Recurrence is the return of cancer after a period of time has passed since remission. It may return to the same place in the body where it began, such as in the pleura for mesothelioma patients, or it may come back in some other part of the body. Because recurrence is common, all patients who have gone into remission from any type of cancer are encouraged to be screened regularly for cancer.
For mesothelioma, complete remission is extremely rare, but partial remission is possible. When the cancer progresses again after partial remission, it is not technically called recurrence, but it is a worsening of the disease and can be just as devastating. Most patients in partial remission can expect that the cancer will eventually start spreading again.
If you or a loved one is going through recurrence of mesothelioma, or progression after partial remission, it can be a difficult experience. Even if you knew to expect this it is hard to cope with getting sick again after feeling well and as if you had beat cancer. It is important to rely on supportive loved ones during this time and to talk to your doctor about treatment options. When a recurrence happens locally, radiation or surgery are often the best options for eliminating the recurring tumor. If it is more distant from the original site, systemic chemotherapy may be a better choice to target metastatic tumors.
Remission is like a magic word in cancer and all patients strive for it, as do their doctors. If you are living with mesothelioma, it is important to understand what remission means and how possible it is for any one individual. There are many factors—different for each patient—that can affect the odds of remission and recurrence or progression.
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