Treatment Terminology: Remission Meaning vs. Cancer-Free

When people ask if my cancer is cured, I tell them I am "currently N.E.D." This odd-sounding term is embraced in the cancer community, and the condition is certainly sought after, as N.E.D. stands for no evidence of disease. It means that all the tests and scans show no evidence that there is any cancer remaining in my body. Another common term used is "complete remission," meaning basically the same thing: Doctors have not found any indication that cancer remains.

Complete remission and N.E.D. are ideal outcomes after cancer treatment, but it is important to distinguish these terms from "cancer-free" or "cured." The distinction between the terms is the issue of detectable evidence. Remission allows for the possibility that some microscopic, undetectable cancer remains in the body, while cancer-free indicates exactly what it sounds like: the patient is entirely free of cancer. However, according to the National Cancer Institute, being called cancer-free is still a misnomer, as it is not currently possible to determine if a patient is completely and truly cancer-free.

It is also possible to complete treatment and be in partial remission, meaning that most of the cancer is gone, but some evidence of the cancer can still be detected.

Detection

There are a number of scans that are used in cancer detection, both for diagnosis and for tracking through the treatment process. Some of these scans can be quite expensive, and some carry health risks of their own, so they are prescribed judiciously. Scanning technology commonly used in cancer detection includes mammography, CT scans, ultrasounds, PET scans, and even X-rays. Cancer-detection technology helps to locate and map growths and tumors, or areas where sufficient cancer cells have combined to form a mass.

Indicators of Cancer

Cancer can be detected in a few ways: through bodily reactions such as a protein by-product, a mass, or by tumor markers. Tumor markers indicate the possibility of cancer that can be detected in blood, urine, or other tissue. Different types of cancer will have different tumor markers, and each must be tested for individually. Doctors may use the tumor markers in conjunction with scans, surgery notes, and physical exams to determine the extent of the cancer and the effectiveness of treatments.

To date, however, there are a number of shortcomings to using tumor markers for cancer detection, according to the American Cancer Society. For instance, the tumor markers may be elevated for reasons unrelated to cancer and give a false positive. In fact, the tumor marker may require a large amount of cancer cells in order to be elevated, and some people with cancer do not have elevated tumor markers at all. The effectiveness of tracking tumor markers varies with the type of cancer and its stage. These markers can be helpful in the treatment and monitoring of certain cancers, but in some early-stage cancers, they are not helpful to the medical team and may not be tracked.

Cause for Celebration

Of course, I wanted to be told that I was cancer-free at the end of my treatment, and I wanted a guarantee that it would never return, but cancer doesn't work that way. Instead, I was told I was N.E.D., meaning that I had the best-case scenario after cancer treatment, and I'm thrilled with that. At the completion of cancer treatment, when the doctor says that there is no evidence of disease, it's a cause for celebration. After that, it's time to turn attention to a healthy lifestyle and routine follow-ups and screenings to maintain health, and if necessary, catch any recurrence as early as possible.