I’m aware that people who have cancer can sometimes die from other causes, and that some cancers are very slow-growing and people who have them typically die of other causes first. That’s not what I’m asking about.
I have this idea that sometimes cancer will spontaneously go into remission even in the absence of any treatment (and that this is sometimes the basis for various miraculous or quack cancer cures, who claim success in instances such as these).
Is this correct?
Untreated cancer will definitely kill you unless something else kills you first.
Untreated cancer may go into remission, possibly for several years, but it will eventually come back.
One of the advancements in cancer research since my mother died 30 years ago is that pathologists can now look at a tumor cell and tell whether the tumor may have come from an earlier bout with cancer.
I had a melanoma (Stage IA) removed. It was a mole on my leg that turned dark and I eventually got looked at. The thing is, the mole had been there for decades, and to be honest it “turned dark” probably 10 years before I went to the doctor. It hadn’t changed (based on photographs) in at least 7-8 years confirmed. Why did I wait so long? I’m stupid.
But I’m also lucky, because IA is basically nothing in terms of melanoma, only in situ is “better.” But I raised the question "so I left this on its own for so long and it ends up it’s melanoma, I asked my doctor “so why didn’t this get worse?” In his words, some melanomas can basically sit at the same state of development indefinitely. He referenced some literature in which a patient had an untreated melanoma (these are all malignant growths of the skin by the way) that had not changed, spread, or grown in 40 years.
Intrigued by this at the time I did some more reading and found that lots of cancers actually just “stop” developing at a point where they aren’t fatal. They can continue growing/spreading later and kill the person, which is why it’s important to get them all treated, but some cancers untreated likely would not have killed the person during their natural life span.
Like all cells, cancer cells also die over time. Sometimes for reasons not entirely understood, some cancerous tumors will enter a state where more of the cells are dying than are replaced through replication, and in essence the tumor just “dies” and dissipates. There’s been a lot of work at trying to stimulate the immune system to cause this to happen deliberately. I think incidentally melanoma is one cancer they’ve had some success in trials doing this with, as I believe something about melanoma cells make them easier for researchers to “target” with therapies than many other types of cancer.
Here’s a relevant NYT article link.
Also, don’t take my above story as “don’t worry about a mole that got darker and stayed that way for years.” To be honest I was extremely stupid. I can show you a lot of stories of people who ignore melanomas for only a few months, and by the time they get them looked at the cancer has spread through their lymph system to distant organs, and at that point the vast majority of patients will not survive more than 5 years.
How about prostate cancer. in many cases, it grows so slowly that people die of other causes. Some doctors feel treating it is not worthwhile.
A number of types of cancer can be so slowly progressive that they’ll never kill you unless your lifespan exceeds 150 years or so. And other types of cancer actually end up going into remission on their own.
The devil is in figuring out which is which, and when to leave alone (since treatment is associated with a LOT of morbidity) and when to intervene. That’s one of the big problems with prostate cancer; many prostatic cancers seem to resolve on their own, others progress so slowly they’re never going to be a threat. Yet others need early and intense intervention to save lives.
That scenario is explicitly excluded in the OP.
Is that certain types of cancer, or coud it happen with any cancer?
[The reason this came up is because there’s a guy in my neighborhood whose esophogeal cancer did not respond to any treatment and in fact spread to other parts of his body, and he’s now in a hospice-like setting. What I’m wondering is if there’s some chance, however small, that the cancer will spontaneously recede.]
I think this is pretty much it.
Tumors can certainly shrink and even disappear. A tumor is a complex environment where all sorts of factors help and hinder a tumor’s growth, and one small change might tip the balance into remission.
However cells in a tumor are usually rapidly mutating, so tumors can apparently go into remission one minute, and then bounce back as a more aggressive grade of tumor the next, as a kind of natural selection is taking place.
Furthermore the definition of cancer includes that the damaged cells can/have invaded other tissue (metastasized), and given the description above you can imagine why the long term prognosis for metastases without any treatment is not good.
Do you have a cite for this assertion, of eventual relapse? Yes, some (maybe even many) remissions do recur, but recurrence is NOT inevitable.
Could maybe happen with any. More likely with some cancers, and some stages. Less likely with others. Vanishingly rare to never documented as having happened for others.
If metastases are present and causing physical symptoms, it’s pretty damn unlikely.
The guy is a shell of his former self, but my impression is that this is more from the chemo than from the cancer itself (though I could be wrong about this).
Could you go on about this? Either in this thread or perhaps even one you might start as I’m sure that would be of great interest to many people.
That’s a huuuuge complex topic, one for which I lack time. Here’s a patient education summary of the risks and benefits of watchful waiting vs. treatment for low risk prostate cancers from UpToDate.com:
How do I choose among the different treatments? — First, make sure you understand all the facts about your choices (table 1). Ask your doctor any questions you have. Then to help you decide, think about how you feel about these issues:
●What the treatment involves
●Benefits of the treatment – With active surveillance, men can avoid the side effects from surgery or radiation for as long as possible. With surgery, external-beam radiation therapy, and brachytherapy, the cancer is treated right away before it can grow or spread.
●Downsides and side effects of the treatment – Men who choose active surveillance need to be monitored by their doctor for a long time, possibly for the rest of their life. This might include having many biopsies. Another downside of active surveillance is knowing you have cancer and worrying about it. Also, sometimes the cancer starts growing quickly and becomes harder to treat.
Surgery, external-beam radiation therapy, and brachytherapy can all cause trouble with sex. This includes trouble getting or keeping an erection. With surgery, this problem usually happens right away. With external-beam radiation therapy and brachytherapy, this problem can happen later on.
Surgery can cause incontinence, which is when people leak urine. Also, side effects such as pain, infection, and bleeding can happen with any type of surgery.
External-beam radiation therapy and brachytherapy have short-term and long-term side effects. Short-term, they can cause frequent bowel movements and other bowel problems. They can also cause problems with urination, including the need to urinate often or pain with urination. Long-term, these treatments sometimes make men leak urine, but this is less common.
●How the treatment could affect your sex life – Active surveillance doesn’t usually affect a man’s sex life. But surgery, external-beam radiation therapy, and brachytherapy can cause trouble getting or keeping an erection. If you have problems with these, there are treatments (medicines or devices) that might be able to help.
Your treatment might also depend on your age and general health. For example, younger men in good health often choose surgery. Older men, especially those with other medical conditions, might choose active surveillance.
Also, people with certain medical conditions cannot have some treatments. For instance, men with long-term diarrhea usually can’t have external-beam radiation therapy or brachytherapy.
What are the chances my cancer will come back after surgery, external-beam radiation therapy, or brachytherapy? — After all of these treatments, there is a very low chance that your cancer will come back.
How do I work with my doctor to make a decision? — To make a decision, let your doctor know how you feel about the different treatments and whether there is something specific that worries you. Then listen to what your doctor has to say about his or her experiences with men who had situations similar to yours. Together, you can decide which treatment is right for you.
Although (obviously) rather uncommon, there are a few types of cancer that have been well documented to undergo spontaneous remissions (and presumed cure).
Malignant melanoma
Renal cell carcinoma (kidney cancer)
Lymphoma (cancer of the lymph ‘glands’)
Spontaneous remission of other cancers can occur, but less frequently.
Sadly, in this instance the odds of the cancer disappearing are vanishingly small.
This could be so. It should be pointed out, though, that untreated metastatic cancer often has a very ugly progression, leaving its victims cachectic and suffering from grievous complications (which chemotherapy or other interventions may prevent or alleviate even if they do not cure the patient).
For instance, look up breast carcinoma en cuirasse, or better (from a peace of mind standpoint) just read this article:
I mention this only because alt med advocates like to harp on the miseries that can be associated with mainstream cancer therapy, but never seem to mention what cancer does on its own.
OTOH, a recent study says that getting chemotherapy near the end can actually make life worse.
It’s true that cancer will always kill you if something else doesn’t kill you first, but then, that’s true of absolutely any malady. A hangnail will always kill you if something else doesn’t kill you first. It’s just that, with a hangnail, it’s overwhelmingly likely that something else will kill you.
Also, if we’re talking about the cancer coming back after a spontaneous remission, one must also be careful to distinguish this from the patient just getting a completely new cancer. If you can get cancer once, you can get it again, especially if you have risk factors like smoking or environmental radiation exposure.
Hangnails are self-limited conditions that almost always resolve on their own. Many disorders and conditions don’t kill.
Or am I missing something in your statement?
Allrighty, then. I feel a little better already!