When a person is diagnosed with a chronic illness like cancer, inflammatory bowel disease, multiple sclerosis, or rheumatoid arthritis, receiving a prognosis of possible remission can sound encouraging. Remission means that the symptoms of the disease are reduced or gone altogether. But does remission mean the same thing as being cured? Understanding the differences between remission and a cure can help patients develop realistic expectations about their prognosis.
What is remission?
Remission refers to a period when the signs and symptoms of a chronic disease are reduced partially or completely. During remission, a patient feels better and can function more normally. Blood tests, imaging tests, or biopsies may show no evidence of disease activity. However, patients in remission are not considered cured.
The length of remission varies. For some patients, remission lasts months. For others, it can go on for years or be indefinite. Some people remain in remission permanently after treatment ends, while others relapse periodically when symptoms flare up again.
Types of remission include:
- Partial remission – The disease is still active but at reduced severity.
- Complete remission – All measurable signs of disease are absent.
- Stable remission – Remission that continues with ongoing treatment.
- Sustained remission – Stable remission that lasts for years.
The level of remission depends on the disease, the treatment given, and the individual patient’s response. Even in complete remission, microscopic disease can remain in the body. Over time, it may become active again.
What does cured mean?
A cure means that the disease is eliminated entirely and will not come back. It’s as if the person never had the disease at all. While remission can last for years, cured means the disease is gone for good.
Cures are possible for some acute short-term illnesses like bacterial pneumonia which can be eradicated with antibiotics. But there are very few cures for long-term chronic diseases. Exceptions include hepatitis C, which can now be cured in most cases with new antiviral drugs. Childhood leukemia is also considered cured after five years with no recurrence.
Technically, the term “cure” should only be used when there is no trace of disease over a long time after treatment ends. Doctors are cautious about using “cure” because diseases like cancer can recur years later, even decades after treatment.
How is remission different from a cure?
There are several key differences between being in remission and being cured:
Presence of disease
In remission, evidence of disease is reduced but not necessarily eliminated. Tiny areas of cancer cells or inflammation may still be present at a level undetectable with scans or tests. With a cure, all traces of the disease are gone.
Ongoing treatment
Remission often requires continuing treatment such as medications to maintain it and keep the disease suppressed. This is called maintenance therapy. A cure means treatments are no longer needed.
Risk of recurrence
A chronic disease like lupus or multiple sclerosis that is in remission can flare up again at any time. A cured disease like tetanus will not recur after recovery. Remission offers a reprieve from symptoms. A cure offers lifetime freedom from disease.
Long-term uncertainty
Remission provides relief but not certainty about the long-term outlook. A cure provides confidence that the disease is gone for good. Having an incurable disease that goes into remission means coping with uncertainty about the future and potential relapse.
Sense of hope
Remission offers hope and progress but not necessarily optimism about a permanent cure. A cure provides lasting hope and optimism about reaching a disease-free state.
Quality of life
In remission, quality of life often improves substantially but some limitations may remain. A cure enables resuming life fully with no restrictions imposed by disease.
Examples of diseases where remission is possible
Many serious chronic diseases can go into periods of remission where symptoms decrease or disappear, but a permanent cure is not typically achieved. Examples include:
Cancer
Partial or complete remission is possible with cancer treatment. But cancer cells that evade treatment can lead to recurrence, even after years of remission. Using “cure” is controversial since cancer can return. But childhood leukemias are often considered cured after 5+ years of no recurrence.
Multiple sclerosis
MS flare-ups can alternate with periods of remission when symptoms fade away. Remission may last months or years but MS is not considered curable with current treatments.
Rheumatoid arthritis
RA causes joint inflammation and pain. Medications can induce remission by controlling autoimmune flare-ups. But some level of disease usually persists, and RA is not considered curable at this time.
Inflammatory bowel diseases
Medications can help induce remission from Crohn’s disease and ulcerative colitis. But the underlying intestinal inflammation is incurable, and most patients experience relapses.
Chronic hepatitis C
New antiviral drugs can now eradicate hepatitis C virus from the body, effectively curing the chronic infection. Prior treatments caused only temporary remission.
Depression
Depressive disorders can improve with treatment but may recur periodically. Remission means symptoms resolve temporarily, while cured implies permanent absence of depression.
What are the chances of remission for different diseases?
Remission rates vary for different diseases based on multiple factors:
- Type and stage of disease
- Treatment used
- Individual patient factors
- Lifestyle measures and self-care
- Access to quality medical care
Here are some approximate remission rates for certain conditions with adequate treatment:
| Disease | Remission Rate |
|---|---|
| Breast cancer | 75-90% |
| Colorectal cancer | 50-60% |
| Non-Hodgkin’s lymphoma | 70-90% |
| Childhood acute lymphocytic leukemia | 90% |
| Ulcerative colitis | 45-80% |
| Crohn’s disease | 50-60% |
| Multiple sclerosis | 60-70% |
| Rheumatoid arthritis | 50-60% |
| Lupus | 60-65% |
| Severe depression | 60-70% |
Remission offers hope of symptom relief. But for many chronic conditions, current treatments cannot offer definitive cures in most patients. Having realistic expectations about remission can help patients make informed treatment decisions.
What are the benefits of achieving remission?
Although remission does not mean cured, reaching remission has many important benefits:
Symptom relief
The most obvious benefit is reduction or resolution of symptoms. This can lead to dramatically improved quality of life and ability to function.
Halted progression
Remission means halted disease progression. Tissue damage and organ dysfunction are limited compared to active disease.
Preserved health
Remission helps preserve overall health. Complications, disabilities, and risks of serious outcomes are reduced versus uncontrolled disease.
Lower mortality
Better survival rates are seen when remission is achieved. Active inflammatory diseases and cancers have higher mortality risks.
Treatment regimens
Treatment intensity can sometimes be lowered when solid remission is reached. This reduces treatment side effects and burdens.
Psychological benefits
Remission has positive psychological effects, with less anxiety about the disease and improved coping abilities.
Social and economic benefits
Ability to work and fulfill social roles improve. Out-of-pocket medical costs decrease. Disabilities are less likely.
What helps boost remission rates?
Certain strategies can help improve remission rates for some conditions:
Optimal medical treatment
Taking medications reliably as prescribed boosts chances of successful disease control and remission depth and duration.
Lifestyle measures
A healthy diet, regular exercise, good sleep habits, and stress reduction enhance well-being and reduce disease activity.
Tight monitoring
Frequent lab tests and doctor’s visits allow prompt medication adjustments at the first sign of recurrence.
Disease management skills
Learning tactics to recognize symptoms early, manage flares, and prevent emergency complications keeps disease controlled.
Support system
Having a good personal and medical support network offers encouragement and assistance to promote remission success.
Hope and optimism
A positive attitude empowered with self-efficacy helps patients stay motivated to maintain remission diligently.
Clinical trials
Participating in research offers cutting edge new therapies not yet widely available to potentially induce deeper remission.
Coping tips for living with chronic diseases
Coping well is vital for those living with an incurable chronic illness. Some helpful strategies include:
Monitoring carefully
Check for signs of recurrence and report them promptly. Early action prevents complications.
Adhering to treatment
Follow the medication regimen faithfully and keep all appointments to sustain remission.
Practicing self-care
Make healthy lifestyle choices, lower stress, and get emotional support to promote well-being.
Planning realistically
Have plans to adjust work, activities, and finances if the disease worsens. Prepare advance directives.
Embracing positives
Focus on capabilities, not disabilities. Celebrate small victories. Find purpose and meaning.
Adapting flexibly
Accepting limitations with flexibility allows more enjoyment of what is possible. Enable independence.
Learning about the disease
Understanding the condition allows better monitoring and decisions about treatments.
Joining support groups
Connecting with others facing the same challenges provides solidarity, advice, and hope.
Conclusion
Remission offers significant benefits by reducing symptoms and progression of chronic diseases. But it is not the same as a permanent cure. Having realistic expectations about remission can help patients cope with uncertainty and make the most of times when their disease is well-controlled. Participating actively in care, engaging social support, practicing self-care, and focusing on positives are key tactics for living well with chronic illness.
