Remission is the reduction in or disappearance of cancerous tumors and cancer symptoms. It can be partial or complete, with complete remission considered effectively a cure. Because mesothelioma is so difficult to treat and is considered incurable, even partial remission is 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.
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 who achieves partial remission will see a big improvement in symptoms and will feel much better. The medical team will be able to see sizable reductions — although not complete elimination — in the tumors and cancer cell markers in the body.
Mesothelioma, both pleural and peritoneal, is difficult to treat, especially 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. For others 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 living longer.
Complete remission means all symptoms and signs of cancer are gone. Complete remission is rare in mesothelioma patients because this aggressive cancer spreads so rapidly. It is difficult to eliminate every tumor and every cancer cell in a mesothelioma patient. It is rare, but does happen. When a patient achieves complete remission, it may feel like being cured of cancer, but it is no guarantee that the cancer will never return. 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 call complete remission a cure, but with mesothelioma it’s tricky. It is considered incurable, but rarely people do experience remission. Even for these people, though, it is likely that the cancer will return at some point. It is difficult to understand why remission or curing mesothelioma is so tough.
No one knows for sure, 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. Mesothelioma’s long latency period means it is most often diagnosed when it has progressed past early stages. If 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 story, published in 2007, 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 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 mesothelioma remission occurred in a 71-year-old Japanese patient diagnosed with peritoneal mesothelioma. After surgery and chemotherapy she went into complete remission 223 days after the initial operation. But cancer recurred in her pleura about eight months later.
Recurrence after Remission
Patients who experience remission must be aware that recurrence, or a return of cancer, is always possible. 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 area. Because recurrence is common, all patients who have gone into remission from any type of cancer should 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. No matter what it is called, it is just as devastating. Most patients in partial remission can expect their cancer to someday spread again.
If you or a loved one have a recurrence of mesothelioma, or progression after partial remission, it can be difficult. It is hard to cope with getting sick again after feeling well and hoping you 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 the Holy Grail all cancer patients and doctors strive for. If you are living with mesothelioma, it is important to understand remission and its limits. Many factors — different for each patient — affect the odds of remission and recurrence or progression.
Page Edited by Dave Foster
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