"Cure" or "Remission"?

Emily2008

What's the difference?  Just trying to understand the terminology.

 Can you tell I had my last chemo today???

Anonymous

CONGRATS! Last chemo day is a wonderful day!

I've heard many of us say you can never be sure you're cured, but there's always hope!

RIV54

NED is the term most of us use. Its my understanding that there is no cure. As Laura said "there's always hope".

Curlylocks

Congratulations on finishing chemo, what a wonderful milestone... 

Remission means you are cancer free at present, also known as NED (No Evidence of Disease) which is where all of us want to be!  Unfortunately, not meaning to sound negative there is no cure for breast cancer. 

I  am a 3 year survivor living with breast cancer and living well!!! 

I too WILL NEVER GIVE UP HOPE that one day they will find a cure!!!

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bluewillow

Hi,

I am a one year survivor. Emily2008, not long after I was diagnosed, I asked that very question at my oncologist's office and was told "Stages 1, 2, and 3 can be cured and Stage 4 can be put in remission and treated very effectively for a long time".  Whether or not anyone else agrees with that statement, it sure was encouraging to me to hear those words!  And interestingly, I have never heard them use the term "NED"-- I guess there are differences in terminology...

 Emily2008, congratulations on finishing chemo!  Best wishes to all for a long healthy future! 

Mary Jo

Beesie

Mary Jo, I think the difference in opinions about whether BC can be cured relates to the problem that we can never know for sure who has been cured.  Most women who have Stage 1 and 2 BC, and many who have Stage 3 BC are cured, but the only way we can know this is if we never have a recurrence.  That's why most of us use the term NED. The longer we stay NED, the more likely it is that we've been cured (since recurrence risk goes down as the years go by).  And I think the reason that most doctors and experts say that BC can't be cured is because they can never tell a patient with 100% certainty that they've been cured. 

There was a post on this topic a few months ago and it was really interesting to see all the different perspectives on this.   

HeatherBLocklear

My team agrees with Beesie's take, and so do I. I don't think BC can ever be considered "cured" (although some people, like our own Shirlann, seem to have beaten the statistics). Instead, it's a question of how long we can go on without disease returning or progressing. That time lapse varies enormously; many women die of other causes before their BC can come back and (excuse me!) finish them off.

Love,

Annie Camel Krappe

otter

Emily, this is my understanding of the difference between a "cure" and "remission":

Cure:  A "cure" is when the cancer is completely gone and does not--no, will not--come back.

Remission:  According to the glossary at http://breastcancer.about.com/, "remission" is, "A period of time during which symptoms of [cancer] are reduced (partial remission) or undetectable (complete remission). In the case of breast cancer, remission means that tests and imaging do not show evidence of the cancer, and that a doctor cannot see signs of the cancer during a clinical exam. It does not mean the same thing as cure because if even one cancer cell is still in your body, the small possibility exists that the cancer may return."

According to the Northwestern University website, "Doctors use the word 'remission' instead of cure when talking about cancer because they cannot be sure that there are no cancer cells at all in the body.  So the cancer could come back in the future, although there is no sign of it at the time."

As Beesie said, many (most?) oncologists don't like to use the word "cure" anymore, especially in reference to breast cancer.  That's because it is almost impossible to identify which particular women will have their cancer return after it has been treated, and which will not.  Most women with early-stage (especially Stage I) BC are "cured" by their treatment these days, but the fact that they have been cured will not be known unless and until they live a long time and die of something else.

This is my opinion, but I think oncos don't use the term "remission" very often, either.  I think it's used when there is some likelihood that the cancer is still present, but it is not detectable at the moment and there are no symptoms.  So, someone with a small, well-differentiated Stage I BC would probably not be told her cancer is "in remission."  Instead, she would probably be told there is no longer any evidence of disease (NED).

I have not asked my oncologist about this.  I guess I'm accepting the fact that there is no assurance of a "cure" for BC.

otter 

Genia

Thanks to those of you who explained this a little better.  I've often wondered the same thing.

I will gladly settle for remission........I just want it GONE!!!

Emily2008

Thank you, ladies.  I want to be able to say I'm "cured" since "remission" conjures up in my mind nasty little cancer cells lurking in my body just waiting for an opportunity to rear their ugly little heads.  But, I understand that there is no way to say for certain that I'm cured.  Mostly, and you may laugh at this, I want to know what to say to other people!  I think for my kids I'll say "Mommy's cured.  She had cancer but it's all gone."  To friends and family I may say "I'm doing well and there's no evidence of cancer."  To myself, I'll say, "I'm in remission."  Can you tell I tend to overthink things?  Sheesh!

 Thanks for the inputs.

debk55

Hi All,

My onc did tell me that I was in remission technaically. I had a mast and the had really good matgins and no nodes involoved, but that without chemo I had a  30 % chance of reoccurance.. He di state that I was not cured just in remission    Hope that helps some. 

otter

Emily, I agree with you.  What words I use will depend on the audience.

For a young child (like my granddaughter), I would probably say, "The cancer is all gone, and I'm going to be fine."  That's all a young child needs to know and probably all he or she can handle.

For adult family members and friends, I'm a bit more circumspect.  Friends and colleagues often say to me, "So, you're cured, right?  They found it early, and got it all?".  I'll respond that I hope so, but it's really hard to know for sure.

I often take such opportunities to educate people (gently) about cancer risks and prognosis.  I'll say that, as far as my doctors are can tell, my cancer is gone; but with BC it's impossible to say that I've been "cured"--even after the magic 5-year period so many people think is important.  I'll tell them there will always be some risk that my cancer will recur.  I've done everything I can, in my treatments, to keep that from happening.  If they're really close friends and have a good sense of humor, I'll point out that the only way I'm going to know if I've been cured is when I die from something else.

If it's a stranger asking me, or if the situation is a bit formal, I'll just smile and say, "Yes, I've finished my treatments and I'm fine."  Technically, that's not true, because I'll be on an estrogen blocker for at least the next 5 years.  But, the details are really none of their business.

otter 

bluewillow

Hi! 

On this beautiful crisp Saturday morning, I'm decluttering and throwing out stuff, thanks to inspiration from Abbadoodles' Making Do With Less thread under the Moving Beyond Cancer forum -- check it out, it's great!  

I just found this clipping of an ABC News transcript from an interview with Dr. Susan Love, M.D. entitled "Can Breast Cancer Be Cured?"  (copyright 2007 ABC News Internet Ventures)  It follows:

Question: Can breast cancer be cured? 

Answer: Breast cancer can be cured.  In fact we cure three-quarters of breast cancer; the problem is when somebody is diagnosed with breast cancer, we can't tell that woman that she is cured, until she dies at 95 of something else.  So, we know we cure breast cancer, but we never know if any one particular person is cured at any one time.

It pretty much says what all the combined responses here say.

For some strange reason, I found great comfort in this quote, and this is one thing I will keep. I found it a week after I was diagnosed and I found it very uplifting and encouraging. Have a great weekend, all.

Mary Jo

msphil

Hello sweetie, when I was cancer free for about 2 yrs i would say "in remission" but now that I am 15 yrs cancer free next month I consider "myself" CURED, because with HOPE and POSITIVE thoughts, and most of ALL with bekief that my Lord N Saviour Jesus Christ , who got me through all this and continues to SUSTAIN me, yes I consider myself CURED. GOD BLESS US ALL. msphil PS the medical community decides whose (cured) and whose in(remission) no I depend on HIM.

Beesie

Hope, positive thoughts and religious belief may help some individuals get through a breast cancer diagnosis and BC treatment, but they have nothing to do with whether one remains cancer free.  Some of the most wonderful, hopeful, positive and religious women I've met on this board hang out in the mets thread.

The medical community doesn't decide who is cured; the medical community does whatever they can to cure each and every one of us.  Most of the time they are successful; some of the time, sadly they are not.  And, as Dr. Love said (thank you Mary Jo for posting this), until we are each 95 years old and we die of something else (hopefully peacefully in our bed at home, surrounded by family & friends) we won't know for sure that we've been cured.