Remission: What does it mean to be in remission?

What does remission mean?

A child with cancer is said to be in remission when the symptoms of the disease disappear or lessen after treatment. Depending on the impact of the treatment, remission can be either partial or complete; however, this doesn’t mean the cancer is fully cured and there is always a risk for recurrence.

What does partial or complete remission mean?

If a child is informed that they are in remission, this means that after conducting a number of tests related to their specific cancer, they have concluded that the signs and symptoms of the cancer has reduced.  There are two types of remission:

Remission and MRD

In the specific case of blood cancer, if the levels of leukaemic cells are below one thousand million, the cancer can’t be detected by a microscope. This means that even in remission, the child’s cancer may relapse due to Minimal Residual Disease (MRD). In 2003, after years of research (and a £3 million contribution from Children with Cancer UK), a new technique emerged that helped doctors predict the risk of recurrence due to MRD. It is thought that this innovation may drive the survival rate for childhood ALL above 90%.

What happens in remission?

Being in remission, whether partial or complete, is an important milestone in the journey of children fighting cancer. It is a moment to take a break from treatment and re-enter a more normal life. However, monitoring the child and the disease will remain very important to ensure the cancer is kept in check. 

Once in remission, the doctors will create a plan for the next months (or years) with the objective of monitoring and ensuring the cancer doesn’t come back and also being able to react as quickly as possible in case of recurrence. The new plan will be tailored to the child’s new circumstance and will involve regular visits to the doctors, tests, adapted medication and other therapies. It will mean a step back from the pressures of treatment but not a complete independence. 

While being in remission can bring an air of optimism, children and families will also have to handle the uncertainty of potentially seeing the cancer recur. Having the medical needs covered will help, but it is also important for families to focus on communication with their child. Children should be able to feel good about being in remission and know that it is an important step, as well as being comfortable communicating if something feels bad.

Will the cancer recur after remission?

There is always a risk of cancer recurrence, so it is good to see remission as a positive step in the recovery journey, but not as the final one. It is very useful to lean on the team of doctors as much as possible. They will be able to communicate the possible future scenarios the family might face and they will also know the recurrence rate for the cancer the child is battling.