Spontaneous remission

As spontaneous remission, also called spontaneous regression, is in the field of oncology (ie cancer ) an unanticipated improvement or recovery ( healing ) refers. For spontaneous remissions Everson and Cole called in her book from 1966 the following definition: As a spontaneous remission is called a complete or partial disappearance of a malignant tumor in the absence of all treatments or treatments for which so far no evidence of efficacy was performed. In the case of cancers of the hematopoietic system is called spontaneous remission, in solid tumors of spontaneous regression; However, these two terms are often used interchangeably. Both are forms of spontaneous healing in cancer.

Frequency

It took a long time, that spontaneous remissions in cancer are a rare phenomenon and that they accumulate in certain forms of cancer and are rare in other forms of cancer ( more common in malignant melanoma, renal cell carcinoma, malignant lymphoma and childhood neuroblastomas on, rare in bronchial and breast cancer, colorectal carcinomas, invasive cervical cancer, gastric or ovarian cancer and acute leukemia ). In a review article, a frequency of 1/100.000 cancers was estimated, this value may be different in reality significantly up or down. For one thing, not all spontaneous remissions are recorded, either because the case has not been well documented because the doctors not published the case or because the patient in question is simply not presented himself again at the clinic. On the other hand hardly any cancer patient is left untreated for 100 years, so that the influence of the respective treatment is unclear.

However, It is possible that the incidence of spontaneous regressions, at least for small tumors is much higher than was previously thought. In a carefully conducted study of mammography in 2008 a spontaneous cure rate of 22% was found in breast cancer.

Causes

In medical circles, the programmed cell death ( apoptosis) or the inhibition of angiogenesis ( neovascularization ) is often expressed in tumors as a cause of spontaneous remissions in cancer. However, neither apoptosis nor angiogenesis causes, but biological mechanisms at the cellular level, which in turn require a trigger. In many cancer cells, apoptosis is eliminated by mutations of angiogenesis activated by mutations; Cancer exists because watching these two mechanisms no longer work correctly. A large number, if not a majority of spontaneous regressions in cancer appear to have a close temporal association with severe febrile infections. If it should be at this temporal coincidence of a causal link, febrile infections should be noticeable as a preventive (prophylactic ), ie the risk of developing cancer, reduce. This was indeed found.

Review article

Rohde Castle describes the year 1918 185 observed spontaneous remissions, Fauvet reported 202 cases between 1960 to 1964, Boyd reported 1966 on 98 cases, Cole and Everson report of 176 cases in the period from 1900 to 1960, Challis reports of 489 cases in the years 1900 - 1987 Brendon O'Regan and Caryle Hirschberg ( Hirshberg ) reported with 1993 of 1385 spontaneous remissions in cancer in the same period between 1900 and 1987.