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Remission is the reduction or disappearance of cancerous tumors in the body. Complete remission means physical exams and scans show no signs of cancer. Partial remission is when the cancer responds to treatment, but isn’t completely cured.
Because mesothelioma is considered incurable, even partial remission is a success. In rare cases, mesothelioma may actually disappear completely, causing a complete remission. Achieving any level of remission usually requires multimodal therapy, but there have been rare cases of spontaneous remission.
There are two types of remission: partial and complete. Partial remission refers to a significant improvement without a complete disappearance of disease. A patient is in partial remission if there is at least a 50 percent reduction in tumor size. A mesothelioma patient who achieves partial remission will experience significant improvement in symptoms.
Both pleural and peritoneal mesothelioma is difficult to treat. This difficulty is largely due to diagnosis after the cancer has developed beyond stage I. For many patients, treatment is palliative, or aimed at making them comfortable and improving their quality of life. For others, traditional treatments combined with emerging treatments or clinical trials could help them achieve partial remission. Partial remission not only means feeling better, but also living longer.
Someone in complete remission has no signs or symptoms of cancer. Some doctors refer to complete cancer remission as “no evidence of disease” or “NED.” Complete remission is rare in mesothelioma patients because this aggressive cancer spreads so rapidly. Eliminating all mesothelioma cells is difficult. It is rare, but does happen. When a patient achieves complete remission, it may feel like being completely cured. However, complete remission does not guarantee the cancer will never return. Although the medical team does not detect cancer cells, they may still be in the body on a microscopic level.
The Difficulty with “Curing” Mesothelioma
Although many people call complete remission a cure, with mesothelioma it’s tricky. Mesothelioma is considered incurable, but there are rare cases of patients achieving remission. However, even for patients in remission, the cancer will probably return at some point.
No one knows for sure why remission is so difficult to achieve for mesothelioma. However, researchers and experts know that mesothelioma spreads quickly and aggressively. The greater the tendency for a cancer to spread, the more difficult it is to control and ultimately to cure. Mesothelioma has a long latency period. This 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 the stories of those who did not survive a mesothelioma diagnosis, there are amazing stories of remission. One story, published in 2007, described a 61-year-old woman diagnosed with mesothelioma who went into spontaneous remission. Six months after her diagnosis, she was disease free. Five years later, she was still in complete remission. Although doctors offered treatment options, she declined them all. Over several screenings months, her doctors watched her tumors shrink and disappear. No one understands what causes spontaneous remission.
Another case of mesothelioma remission occurred in a 71-year-old Japanese patient diagnosed with peritoneal mesothelioma. The patient went into complete remission 223 days after her initial operation surgery. Unfortunately, cancer recurred in her pleura approximately eight months later.
Recurrence after Remission
Patients in remission should understand that recurrence is always possible. Cancer may return to the same place in the body or in some other area. Because recurrence is common, all patients in remission from any type of cancer should receive regular cancer screenings.
For mesothelioma, complete remission is extremely rare. However, partial remission is possible for some. When the cancer progresses after partial remission, it is not technically a recurrence. Instead, doctors call this a progression, or a worsening of the disease. No matter the label, it is still devastating. Most patients in partial remission can expect their cancer to begin spreading again some time in the future.
If you or a loved one have a recurrence of mesothelioma, or progression after partial remission, it can be difficult. Coping with getting sick again after feeling well is difficult. You may also feel like there is not hope of beating your cancer. Support of loved ones is important during these difficult moments.
Also, talk to your doctor about new treatment options. When a recurrence happens locally, radiation or surgery are often the best options for eliminating the recurring tumor. If it is distant from the original site, systemic chemotherapy may be a better choice to target metastatic tumors.
If you are living with mesothelioma, it is important to understand remission and its limits. Many factors affect a patient’s odds of remission, recurrence, or progression.
Page Medically Reviewed and Edited by Anne Courtney, AOCNP, DNP
Anne Courtney has a Doctor of Nursing Practice degree and is an Advanced Oncology Certified Nurse Practitioner. She has years of oncology experience working with patients with malignant mesothelioma, as well as other types of cancer. Dr. Courtney currently works at University of Texas LIVESTRONG Cancer Institutes.