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:
Partial remission – If the tumour or cancer cells haven’t disappeared but have retreated or stopped growing, the child with cancer will enter the stage of partial remission.
Complete remission – If cancer signs and symptoms fully disappear after treatment, patients will be in complete remission. However, despite medical tests, it is impossible for doctors to tell if cancer cells will become active in the future, and therefore can not say the child is “cured”. The terminology they will normally use is that there is “No Evidence of Disease” (NED).
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?
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.
If you have a child that is currently in remission, it is normal to have questions and to try to understand the new situation as well as possible. The three blogs below are first-hand accounts from families affected by childhood cancer and their experiences with being in remission.
Types of cancer
The types of cancer affecting children are quite different from the cancers that affect teenagers and young adults (TYA); TYA cancers are different again from the types of cancer that typically affect adults aged 25+.
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