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What is Remission And How Do We Recognize It

The definition of remission is that it is a medical term ascribed to a cancer recovery; it means that a cancer has responded to a particular treatment favorably. It is not synonymous with a cure, nor does it mean the cancer cannot return. But it is an important term, and experience, to be familiar with.

There are basically two kinds of remission in cancer patients.

A partial cancer remission is one where the cancer decreases or shrinks, but does not disappear completely from the patient’s body. It is still present, and still malignant, but it is more manageable. The patient, in a sense, has bought more time for a complete recovery if the right treatment continues.

A complete remission is the disappearance of the cancer; in this case, the cancer may still return, but the patient is out of danger for the present time.

One should remember that neither of these conditions is a cure; the cancer may come back, perhaps even in a different form or a different part of the patient’s body. Some cancers can recur in the distant future, even after many years of remission.

To determine whether the status of the remission is partial or complete, careful monitoring and maintenance of the patient’s physical condition is needed. Patients must visit their oncologist as often as is deemed necessary, and each visit should include a battery of tests to see if remission, partial or complete, has indeed been maintained.

The tests for maintenance and checking on remissions include regular X - rays and, if available, CT scans, which are repeated periodically to make sure the cancer has disappeared or, in the case of a partial remission, is still at bay. The severity of the test, and its regular application, depends on how visible the cancer is in the initial testing.

A cancer that is pronounced enough to appear on a regular X - ray is obviously a partial remission, and regular testing should be maintained as the treatment continues.

To illustrate: imagine a female patient with advanced (stage IV) Lymphoma. She has enlarged lymph glands under the arm and in the neck; her spleen and liver are swollen as well.

A week of chemotherapy ensues, and all the swellings become smaller; in this event, partial remission is indicated, and she should continue X - ray, CT scan and probably bone marrow tests to indicate how much lymphoma involvement still exists.

A month later, the patient is re - examined; the areas of swelling continue to shrink. After several more cycles of chemotherapy, the patient has no more enlargements or swollen areas. Blood tests, marrow tests and X - rays all indicate that the disease has disappeared. This is a complete remission, also known as a “clinical” remission, since examination and clinical testing revealed the nature of the condition.

Half a year has gone by, and the patient has finished her chemotherapy; examinations reveal her as completely healthy. This is the point at which, to confirm the remission, every test she had that originally indicated lymphoma is repeated. This includes a blood test, CT scan, X - ray and bone marrow samples. If all these tests are negative, and the patient seems to have returned to normal, her status is updated to being in remission, but that status is designated by her testing: clinical, pathological, radiological and cytogenetic remission.

In other words, Clinical remission is determined by a simple blood test. Radiological remission is indicated based upon CT scans. Pathological remission is indicated on the basis of the bone marrow biopsy. Cytogenetic remission is based on the bone marrow study itself, where the genetic and chromosomal structure of the bone marrow has been examined.

All of these conditions, and test results, must be in place before the remission is considered complete.



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