When cancer treatment concluded some of us rang the bell, only to await the next series of appointments to be told “you’re all clear” and that we are discharged from the need of treatment/care either as in remission or have no evidence of disease (NED). There is that ultimate sigh of relief.
It has been the common place; that we often use these terms synonymously overarching the evidence that we have beat cancer. Nevertheless, these terms do have different meanings and vary based on your doctor’s preference and or his or her use of scientific data (blood tests, scans, biopsies, etc.) in support of such findings. Most doctors prefer to use NED or remission. Here’s why:
Remission is a term used to describe a state in which the signs and symptoms of cancer have improved significantly or disappeared, but there may still be a possibility of cancer cells remaining in the body at a microscopic level. Therefore, remission is not the same as being cancer free. There are two main types of remission:
Partial Remission or Partial Response means that the cancer has significantly reduced in size or severity, and the patient is experiencing relief from cancer-related symptoms, but some cancer cells may still be present.
*Dana - Faber's Cancer Institute defines partial remission or partial response signifies a reduction of at least 30% of a measurable tumor within the body.
Complete Remission or Complete Response: In this case, all signs and symptoms of cancer have disappeared, and there is no evidence of the disease through clinical tests and imaging. However, the term "complete remission" does not necessarily mean that every single cancer cell has been eradicated, but it indicates that there is no detectable evidence of cancer using current diagnostic methods.
No Evidence of Disease (NED): NED is a term often used in medical reports to signify that, at the time of evaluation, there is no detectable evidence of cancer using available tests and examinations. It is similar to complete remission in that it implies the absence of clinically apparent disease.
Cancer-Free: This term typically implies that there are no detectable cancer cells or tumors in the body at a specific point in time. It suggests that all signs of cancer have been successfully treated or eradicated, and there is no evidence of the disease.
In summary, while "cancer-free," "remission," and "No Evidence of Disease (NED)" all indicate positive outcomes in the context of cancer treatment, they vary in their level of certainty regarding the absence of cancer cells. Complete remission and NED are more similar in meaning, suggesting no clinically detectable cancer, whereas being "cancer-free" is a little trickier as it is not as specific in medical terminology.
Accordingly, MD Anderson’s Oncologist Phat Le, M.D states “Cancer-free is a little more complicated, because it’s not based on something we can measure. Instead, it implies that not only is there nothing detectable in your body as cancer, but we also believe no residual cancer is left anywhere, so there’s no chance of the cancer ever coming back….” Which is difficult to conclude, because there’s always at least a very slight risk of recurrence if you’ve ever had cancer before.
Patients should discuss the terminology and their individual situation with their healthcare providers to fully understand their cancer status and the implications for their ongoing care and monitoring.