Lymphoma Remission

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To hear that your cancer has gone into remission is like having a smothering weight lifted off your chest. Unfortunately, the idea of "remission", while initially self-evident, does not always translate neatly into the real world. There are dozens of factors involved in making a lymphoma diagnosis and describing the progression of the disease, from the type of lymphoma involved to past history to the patient's age. To fully understand the term "lymphoma remission", you have to look at a few of the more specific terms used by oncologists.

Degrees

With most cancers, the success of treatment is not a black-and-white matter; results lie on a continuum from cured to non-responsive, and all points in between. Lymphoma is no different. Oncologists use a scale of six to eight levels to discuss and quantify the success of various therapies. These levels include the following:

1. Cure - This is only used very cautiously, and even then only for some types of lymphomas. No signs of cancer have been detected in the lymphatic system for a long period. Low-grade lymphomas have a tendency to resurface, even after many years, so it is uncommon to used the word "cure" for any of these.

2. Complete Remission - All signs of the disease have vanished and it is undetectable using current tests. The longer a patient is in complete remission, the better his long-term prognosis, with long-term remission often called durable remission. Patients also enjoy calling this stage No Evidence of Disease, or NED.

2a. Complete Remission (unconfirmed) - All signs point to a complete remission, but there is something suspicious. This could be a lump that may be scar tissue or maybe not, or unclear blood work. Functionally the same as complete remission, but with some doubt mixed in.

3. Molecular Remission - In certain types of lymphoma, like the bone marrow or blood, advanced imaging techniques can allow oncologists to isolate individual cancer cells among thousands of healthy cells. This degree of remission means that macroscopic assemblages of cancer cells are gone, but minute traces remain.

4. Partial Remission - This indicates the tumor has shrunk to half its former size.

5. Improvement - Oncologists may use this to describe a tumor that has shrunk in size, but is still more than half its original size.

6. Stable Disease - This means there was neither an improvement nor a worsening of the disease following treatment.

7. Refractory - This describes a cancer that resists attempts to treat it.

Causative Factors

Several elements can affect remission, including the following:

1. Age - Remission rates tend to be measurably lower among older individuals.

2. History of infections - Certain viruses, such as HIV, Epstein-Barr, or H. pylori can hinder remission or increase the odds of recurrences.

3. Immune Diseases - This includes HIV, autoimmune disease, and induced immune therapy, such as following an organ transplant.

Your oncologist can work with you to make sure you understand the different words being thrown about. Just remember, in most cases, the word remission is a wonderful thing to hear.

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