Fear and unease are natural responses to hearing that one has cancer, which is quite understandable. Survival rates for persons diagnosed with many different types of cancer have increased thanks to the development of potent new treatments that tap into our immune system’s capabilities and new understandings of how cancer cells grow and thrive.
Other cancers, many of which have been deemed hopeless for a very long time, can be managed as chronic diseases, sometimes for a very long period. Not only can some cancers be effectively treated and potentially “cured,” but other cancers can also be managed as chronic diseases.
Acquiring an understanding of the factors that influence a prognosis
According to the American Cancer Society, as of the first of the year 2019, more than 16.9 million people in the United States who had been diagnosed with invasive cancer (cancer that has spread to healthy tissue in the surrounding area) were still alive (ACS). The majority of these people had been given a cancer diagnosis quite some time ago, but they were still alive without showing any signs of the disease.
If you have been given a diagnosis of cancer, your healthcare provider (HCP) will likely take into consideration a number of different aspects when determining your prognosis. (Your prognosis is a method of describing how you might react to treatment as well as your possibilities for recovery.) These are the following:
- What subtype of cancer you have, as well as the location in your body where it was discovered first.
- How large the cancer is and whether or not it has spread to other parts of your body are two important factors.
- the physiology of the cancer cells in their whole. For instance, do they spread quickly or do they mature slowly? Do they possess any particular genes that make them more amenable to treatment?
- Being over the age of 60 and having a concurrent health condition, such as diabetes or heart disease, that may also impair your reaction to treatment is a risk factor.
According to Erev Tubb, MD, a medical oncologist at the Mullica Hill Cancer Center in Mullica Hill, New Jersey, and the medical director of the facility, “prognosis is essentially just a medical term for guesswork.”
“We’re trying to move away from false hope or false fear,” says Dr. Tubb, referring to the efforts of oncologists to find the balance between promising too little and promising too much in terms of the outcomes they anticipate for patients. “Right from the start, I make it a point to establish what I believe to be a reasonable estimate of the patient’s long-term life expectancy based on the most up-to-date information that is available and the patient’s general condition.”
This limited predictability is a direct result of the intricacy of many different kinds of cancer.
Acquiring an understanding of the language used in effective treatment
There are different types of cancer, each of which responds differently to treatment. It might be beneficial for patients to obtain an understanding of the language that is used by healthcare professionals to discuss the effectiveness of therapy against a certain malignancy. Cancers have the potential to be stable, they may go into partial or complete remission, or they may advance to a more severe form of the illness.
The following are some of the most important concepts that need to be grasped:
- Stable disease refers to a condition in which a cancer neither grows nor spreads after treatment; in this case, the patient must be carefully monitored for any changes.
- Patients are regarded to be in a state of partial remission if the size of their tumours has decreased by at least fifty percent or more. You may be able to take a break from the rigours of chemotherapy or other treatments if you have achieved a partial remission. This break will last until the cancer begins to grow again.
- Relapse, also known as cancer’s return, is the term that is typically used to describe cancer that reappears during the first five years after therapy has been initiated.
- Imaging tests must not detect any detectable tumours or other indicators of cancer in order to classify the patient as having achieved complete remission.
Some healthcare professionals use the term “cured” to refer to patients who remain in complete remission following therapy, which means they are free of all signs and symptoms of cancer for a period of at least five years. However, some healthcare professionals avoid using the term “cure.”
Even when there is a strong possibility that a cancer won’t return after therapy, Tubb says he prefers the word “continuous long-term remission” to describe the patient’s condition. This more circumspect evaluation allows for the improbable potential of a recurrence of the malignant condition many years from now. This may occur if treatments leave behind microscopic cancer cells that, at a later time, develop and divide into new forms of the disease.
Bringing the immune system up to speed
Over the course of the last several decades, an improved understanding of cancer on a cellular level has been accompanied by the development of novel methods to the disease’s treatment. These include medicines that are more specific and targeted, aiming targeting specific genes within cancer cells that contribute to the growth and spread of cancer and help cancer spin out of control. HCPs now integrate several of these newer therapies with the tried-and-true methods of cancer treatment, including as chemotherapy, radiation therapy, and surgery, in order to get better overall results.
Immunotherapy is one of the more recent forms of treatment. This treatment makes use of your immune system in order to “recognise cancer as it should,” as explained by Tubb. This makes cancer cells more susceptible to being attacked. Clinics currently employ a number of different immunotherapy modalities to treat patients. In many cases, these therapies have provided long-term remissions in cancers that were once considered to be uniformly fatal. These cancers include advanced lung cancers and kidney cancers, head and neck, liver, and kidney cancers, as well as some forms of melanoma, the most deadly form of skin cancer.
There is a category of medications known as checkpoint inhibitors that have shown to be extremely successful. These medications interfere with a mechanism, often known as a “checkpoint,” that cancer cells utilise to avoid detection by the immune system. As a direct consequence of this, your body’s immune system will be better equipped to detect and eliminate cancer cells. Another method of treatment involves removing the patient’s own immune cells from their bodies, modifying them genetically so that they can attach to and kill particular types of cancer cells, and then reinfusing those cells back into the patient’s bloodstream. This is one method of treating patients who have advanced stages of cancer.
Because of these actions, therapy can be individualised for each individual patient. According to Tubb, researchers have already uncovered genetic commonalities that are shared across a wide range of diseases. This finding may, in the future, increase the treatment options available for a wide range of cancer patients.
Tubb claims that there have already been significant shifts in the way some tumours are treated. Because of these advancements, he now has a guardedly hopeful outlook on the future progress.
Although immunotherapy has the potential to put certain malignancies into long-term remission, not every patient will have a positive response to it. In the meantime, researchers are using what they know about the genetics of cancer to the search for improved methods of predicting which patients are most likely to react well to immunotherapy. HCPs can utilise these types of tools to help evaluate whether immunotherapy — or mix of therapies — may give the best treatment choice for particular patients by analysing patient data.
Even though the progress that has been made is still quite recent, there are some HCPs who are beginning to believe that it is now easier to anticipate the cure rates for some types of cancer. Although it is essential to acknowledge the possibility of a cancer recurrence, many cancer specialists are of the opinion that those who are battling the disease should also be able to hear positive outcomes.