Visiting a doctor can be like going to a foreign country where you don’t speak the language. Sometimes doctors use technical terms to communicate with each other about medical issues, just as pilots and mechanics each have their own languages. I’m sometimes confused when my mechanic is explaining what needs to be repaired on my car, so it’s natural for patients to get confused by the terms that doctors use.
Sometimes doctors skirt around sensitive issues, we use imprecise language to avoid upsetting patients, and we let medical jargon creep into our vocabulary. This only makes things harder for patients.
The Goals of Treatment
For some patients with cancer, the goal of treatment is to cure the cancer. Curing the cancer means that it is gone and will never come back. The patient lives out her normal life expectancy, and the cancer will not end her life early.
Other cancers cannot be cured. If the goal of treatment is not for cure, but to slow down the growth of the cancer, improve quality of life, and/or extend survival, then we call the treatment "palliative". Learn more about the importance of knowing the goals.
The Mission: Remission
So what does it mean when a cancer is in “remission”? Remission means that the cancer has gotten smaller, almost always because of a treatment that has helped. It doesn’t necessarily mean that the cancer has gone away completely. If some or all of the tumors are still visible but smaller, then it’s “partial remission.” If all the tumors have disappeared from the scans, then we use the words “complete remission,” meaning that there is no sign of any cancer.
After several years in complete remission, we often say a patient is “cured.”
Why do we need to wait several years? Because our scans cannot detect small spots of cancer that are less than a few millimeters in size. If a patient is scanned immediately after treatment and there are no signs of cancer, we still need to wait to make sure that there are no microscopic spots that grow over time and become detectable a few years later. For some types of cancer, five years is enough time. For others, it is longer.
What about being “cancer-free”? This can be a confusing term that is used loosely. We really only know that someone is “cancer-free” when several years have passed after treatment and she is considered cured. The situation becomes muddled because some people use the term “cancer-free” to mean “complete remission,” meaning that the scans do not show any spots of cancer after treatment. This is not truly “cancer-free,” because we can’t be sure that there are no cancer cells still lingering until the patient passes the test of time.
Ask Your Doctor
If you are a patient who has been treated for cancer, ask your doctor to clarify two things: