Cancer is a scary prospect for many people. However, the rate of cancer survival is increasing, with 70 percent of people diagnosed with cancer living for over 5 years after their diagnosis1,2. Cancer survivors often experience understandable anxiety about cancer recurrence and uncertainty over whether they are truly cancer-free. This blog will discuss what “cancer-free” really means and why remaining vigilant long after treatment ends is key to long-term successful health.
Remission vs Cancer-Free: What’s the Difference?
Definitions You Need to Know
The National Cancer Institute (NCI) defines remission as “a decrease in or disappearance of signs and symptoms of cancer”3. Remission is often categorized as either partial or complete. Cancer is in partial remission if the extent of cancer within the body or the size of a tumor has decreased in response to treatment. Complete remission is where all signs of cancer, including symptoms, imaging, and blood work, have disappeared in response to treatment4.
At the stage of complete remission, medical professionals will often determine that there is no evidence of disease. It is important that cancer survivors are aware that this does not mean that all cancer cells have been eradicated. Unfortunately, it is possible that undetectable, microscopic cancer cells may still be within the body.
When Are You Considered Cancer-Free?
For the same reasons that medical professionals will not tell you that all cancer cells have been eradicated, they may also avoid using the term ‘cancer-free’. Reaching the 5-year survival mark is an important milestone in cancer remission, often considered to be the point at which the chances of that cancer recurring are low. However, this differs between patients and between types of cancer, and recurrence can still occur decades later5.
Survivor, Patient, or Something Else?
The language surrounding cancer can be confusing, particularly when comparing cancer survivor vs in remission vs cancer-free. The differences between these terms can be summarized as:
- Survivor – you are a cancer survivor from the moment you are diagnosed, regardless of whether you are undergoing treatment, living with cancer, or in remission6.
- In remission – the signs and symptoms of cancer are reduced or have disappeared3.
- Cancer-free – often used when there is no detectable cancer within your body, however, it is impossible to say with 100 percent certainty.
People who have been diagnosed with cancer frequently retain the emotional identity of having had cancer, even after many years of being in remission.
Why Cancer Can Come Back — Even After 10 Years
Dormant Cancer Cells
Cancer cells can survive in a state of dormancy for years or even decades after the initial cancer treatment has been completed. Although thought to be suppressed by the immune system, at some stage these dormant cells may awaken, forming metastatic tumors (tumors at a different site to the original cancer)7. Due to the microscopic nature of the dormant cancer cells, they are essentially impossible to detect, only becoming detectable after they awaken and start to multiply8. This could mean cancer recurrence despite years of apparently clear scans.
Emotional Toll: Living With Long-Term Risk
Cancer survivors in remission must undergo regular follow-ups to ensure that their cancer has not reoccurred. These can be a source of extreme anxiety, with survivors fearful of what scans may find (“scanxiety”), in denial that cancer could recur, and reluctant to continue attending screenings. This can cause significant emotional stress in survivors.
No Symptoms Doesn’t Mean No Cancer
The early stages of cancer are frequently symptom-free or only have generalized symptoms present, which are not exclusive to cancer. The earlier that cancer recurrence is found, the more successful the treatment is likely to be. As a result, it is essential for cancer survivors to attend regular scans, even if they aren’t experiencing any symptoms. Regular scans enable proactive healthcare, where early detection is prioritised, enabling better treatment outcomes, as opposed to reactive healthcare. In reactive healthcare, the focus is on treatment after the condition has progressed, often involving more invasive treatments and with less successful outcomes9.
Cancer Survival Rates Are Rising — But So Are Recurrence Risks
Understanding Survival Statistics
With improving diagnostics and treatment capabilities, the number of cancer survivors is on the rise. In 2022, there were approximately 18 million US cancer survivors, this is predicted to increase to over 21 million by 2030 and over 26 million by 204010. It should be noted that survival stats are not exclusively those who are in remission, but also include those who are getting cancer treatments or living with cancer.
The Role of Early Detection
Improvements in cancer survival can be attributed, in part, to cancer screening programs leading to earlier detection11. Early detection is key to a successful outcome. For example, when detected at an early stage, breast cancer has a 5-year survival rate of over 99 percent. However, when detected at a later stage when the cancer has spread, the survival rate is only 32 percent12. Given the importance of early detection for increasing cancer survival, regular screenings are crucial. Ezra understands the importance of early detection, and our MRI scans screen for cancer in 13 organs, catching potential cancer earlier and making it easier to beat.
Recurrence Patterns in Common Cancers
The majority of cancer recurrences occur within the first 2 years after treatment. After 5 years, the risk decreases even further13. Breast cancer has a likelihood of recurrence of approximately 30 percent, with 50 percent of these occurring within 2 years and 90 percent within 5 years14. Approximately 20-50 percent of people with prostate cancer experience a recurrence within 10 years of initial treatment15. Other cancers vary widely in the likelihood of recurrence, with kidney cancer having only a 13 percent chance of recurrence and glioblastoma (a highly aggressive brain cancer) recurring in nearly 100 percent of patients16.
Why Regular Scans Still Matter – Even After Long Remission
Cancer-Free ≠ Risk-Free
No medical professional can guarantee that all of the cancer is gone. Regular scans are crucial to ensuring that cancer recurrence is caught as early as possible to increase the chances of a positive treatment outcome.
Ezra’s Role in Preventive Screening
Ezra offers full-body MRI scans and low-dose CT scans for specific organs to screen for cancer. Our full-body MRIs can simultaneously screen for cancer in 13 organs. Our scans are fast and non-invasive, providing results and peace of mind within a few days.
Scanning Without Symptoms
The early stages of cancer are often asymptomatic, with symptoms increasing as the cancer progresses to later stages17. Undergoing regular screening, such as Ezra’s full-body MRI, can help discover anomalies and potential cancer before symptoms are present, giving individuals the chance for treatment at the earliest possible stage and increasing their chances of a positive treatment outcome.
Summary
People with cancer are experiencing higher rates of survival than ever before. However, the chances of cancer recurrence can be high, particularly within the first 5 years after treatment. Regular screenings can give you peace of mind and reassurance that the cancer isn’t recurring, and enable you to detect recurrence at the earliest possible stage. Early detection and treatment offer the best chances of a positive treatment outcome. Cancer recurrence can occur decades post-treatment: long-term vigilance is key to maintaining your long-term health.
Ezra scans are fast, pain-free, and help detect potential cancer signs in 13 organs and 500+ conditions. Book your Ezra full-body scan today and stay ahead of the curve.
FAQs
Q: What does cancer-free mean?
A: Cancer-free is commonly used to mean that no detectable cancer can be found in the body, however, doctors cannot guarantee that every single cancer cell is gone.
Q: At what point are you considered cancer-free?
A: You are considered cancer-free when no cancer can be detected using medical tests and there are no signs or symptoms of the disease.
Q: Why does cancer spread after surgery?
A: It is possible that not all of the cancer cells have been removed during the surgery, or that cells have broken away from the tumor before surgery and already spread to other parts of the body13.
Q: What cancer is most likely to return?
A: Glioblastoma, a type of aggressive brain cancer, is the most likely cancer to recur16.
Q: What are the three kinds of remission?
A: Partial remission (a reduction in the size of the tumor or number of cancer cells), complete remission (all detectable cancer has disappeared), and spontaneous remission (cancer has gone into remission without conventional/any treatment).
