REMISSION AND RECURRENCE
Remission is the visual disappearance of mesothelioma from the body and is the goal every patient strives for. Recurrence is the return of mesothelioma after remission. Doctors can manage or prevent a mesothelioma recurrence with continued treatment.
A cure for mesothelioma doesn’t exist yet, so the goal of doctors and patients alike is to reach remission. Mesothelioma survivors are patients who have reached this stage, living for years without the recurrence of their disease. Many specialists believe that one day mesothelioma will be managed like a chronic illness, such as diabetes. This logic fits with the goal of remission to help patients live longer lives. Our Patient Help Team can help you find a specialist with this goal in mind.
The Process of Remission and Recurrence
- Treatment and Remission. The hope of every doctor is that their patient will reach disease remission. Treatment through surgery combined with chemotherapy and radiation offer the best chances of remission. Sometimes experimental therapies like immunotherapy help patients reach remission.
- Follow-up Appointments. Every patient who achieves remission has follow-up appointments. These appointments consist of tests to detect the presence of mesothelioma. The longer a patient has been in remission, the less frequent follow-up appointments will become. But it’s important to keep going in case more treatment is needed.
- Recurrence. Every patient in remission also has the risk of their mesothelioma coming back. When it comes to mesothelioma, which is an aggressive cancer, there is a strong possibility of recurrence. But that doesn’t mean a patient can’t achieve remission a second time.
What is Remission?
Remission is the complete, visual absence of mesothelioma in a patient’s body. When a patient is in remission, there may be undetectable traces of mesothelioma, so continued treatment and monitoring is necessary. Successfully removing mesothelioma tumors from the lining of the lungs, abdomen, heart, or any other location to which the cancer spread is the best way doctors can help patients achieve remission.
The term remission is used instead of cure because mesothelioma, like other cancers, is very difficult to completely remove. Though doctors remove most of a tumor during surgery, microscopic cancer cells may remain in the body after treatment – these cells can lead to the re-growth of tumors in the future.
While doctors have not yet found a cure for mesothelioma, remission is still an amazing achievement. Mesothelioma is an aggressive disease that spreads quickly – removing visible traces of mesothelioma from the body makes an enormously positive impact on a patient’s life expectancy.
Treatment and Remission
Surgery is the only treatment with which doctors can completely remove a tumor.
The most successful surgeries for patients diagnosed with pleural mesothelioma are the pleurectomy with decortication (P/D) and the extrapleural pneumonectomy (EPP). Doctors have helped some patients reach remission by combining these procedures with chemotherapy or radiation therapy.
For example, a study published in 2011 demonstrated that a P/D followed by the application of Alimta/cisplatin and radiation therapy produced a remission period of approximately 16 months in all treated patients. Patients whose mesothelioma returned received additional chemotherapy and radiation therapy.
Doctors used multimodal therapy in pleural mesothelioma patients to produce an overall median survival rate of 30 months – about 2.5 times the average life expectancy.
The most effective treatment doctors use to bring about the remission of patients with peritoneal mesothelioma is cytoreductive surgery with HIPEC, another multimodal therapy.
A recent study comparing the results produced by cytoreductive surgery and HIPEC across multiple treatment centers reported an overall median survival rate of approximately 4.5 years and a maximum of 19.5 years.
What is Recurrence?
Recurrence is the return of a disease after remission. All cancers, including mesothelioma, have a chance of recurrence.
Mesothelioma often returns for a number of reasons. The main reason being that it’s hard to surgically remove mesothelioma. Mesothelioma tumors grow close to important organs, like the lungs, stomach and heart. The proximity of these tumors to vital organs makes it difficult for surgeons to remove the disease completely. Surgeons can remove the bulk of a tumor, but they can’t always remove or destroy all the microscopic cancer cells in the affected area. Some of these cells may be left behind after the procedure, and can cause another tumor to form.
Despite the possibility of recurrence, patients should remain hopeful. More and more doctors are treating mesothelioma as a chronic (ongoing) disease. They focus treatment on managing and preventing recurrence, rather than on removing it completely.
One such doctor is Robert Cameron, developer of the lung-sparing pleurectomy with decortication. Dr. Cameron prefers to treat mesothelioma as a chronic disease, like diabetes or high blood pressure. He focuses treatment on the P/D, radiation therapy and long-term maintenance therapy, all of which he uses to stop a tumors from recurring.
If you’d like to learn more about mesothelioma treatment, get a free copy of our mesothelioma help guide. Reading it can help you understand your diagnosis and find out more about getting the treatment you need.