Spontaneous remission

Template:Short description Spontaneous remission, also called spontaneous healing or spontaneous regression, is an unexpected improvement or cure from a disease that usually progresses. These terms are commonly used for unexpected transient or final improvements in cancer. Spontaneous remissions concern cancers of the haematopoietic system (blood cancer, e.g., leukemia), while spontaneous regressions concern palpable tumors; however, both terms are often used interchangeably.

DefinitionEdit

The spontaneous regression and remission from cancer was defined by Everson and Cole in their 1966 book as "the partial or complete disappearance of a malignant tumour in the absence of all treatment, or in the presence of therapy which is considered inadequate to exert significant influence on neoplastic disease."<ref name="Everson and Cole">Everson T., Cole W. (1968) Spontaneous Regression of Cancer Philadelphia, JB Saunder & Co (Book)</ref>

Frequency of spontaneous regression in cancerEdit

It has long been assumed that spontaneous regressions, let alone cures, from cancer are rare phenomena, and that some forms of cancer are more prone to unexpected courses (melanoma, neuroblastoma, lymphoma) than others (carcinoma). Frequency was estimated to be about 1 in 100,000 cancers;<ref name=Hobohm1>Template:Cite journal</ref> however, this proportion might be an under- or an overestimate. For one, not all cases of spontaneous regression can be apprehended, either because the case was not well documented or the physician was not willing to publish, or simply because the patient ceased to attend a clinic any more. On the other hand, for the past 100 years almost all cancer patients have received some form of treatment, and the influence of that treatment cannot always be excluded.

It is likely that the frequency of spontaneous regression in small tumors has been drastically underrated. In a carefully designed study on mammography it was found that 22% of all breast cancer cases underwent spontaneous regression.<ref name=Zahl>Template:Cite journal</ref>

CausesEdit

Everson and Cole offered as explanation for spontaneous regression from cancer:<templatestyles src="Template:Blockquote/styles.css" />

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Challis and Stam, even more at a loss, concluded in 1989, "In summary, we are left to conclude that, although a great number of interesting and unusual cases continue to be published annually, there is still little conclusive data that explains the occurrence of spontaneous regression."<ref name=Challis>Template:Cite journal</ref>

Apoptosis (programmed cell death) and angiogenesis (growth of new blood vessels) are sometimes discussed as possible causes of spontaneous regression. But both mechanisms need appropriate biochemical triggers and cannot initiate on their own. Indeed, in many cancer cells apoptosis is defective, and angiogenesis is activated, both of these effects being caused by mutations in cancer cells; cancer exists because both mechanisms are malfunctioning.<ref>Robert A. Weinberg (2007) The Biology of Cancer, Garland Science</ref>

There are several case reports of spontaneous regressions from cancer occurring after a fever brought on by infection,<ref name=Hobohm1/><ref>Template:Cite journal</ref> suggesting a possible causal connection. If this coincidence in time would be a causal connection, it should as well precipitate as prophylactic effect, i.e. feverish infections should lower the risk to develop cancer later. This could be confirmed by collecting epidemiological studies.<ref name=Hobohm>Template:Cite journal</ref><ref name=Maletzki>Template:Cite journal</ref>

ReviewsEdit

Rohdenburg (1918) summarized 185 spontaneous regressions<ref>Template:Cite journal</ref>
Fauvet reported 202 cases between 1960 and 1964<ref>Template:Cite journal</ref>
Boyd reported 98 cases in 1966<ref>Boyd W: The spontaneous regression of cancer. Charles Thomas, Publ., Springfield Ill. 1966 (Book)</ref>
Everson and Cole described 176 cases between 1900 and 1960<ref name="Everson and Cole"/><ref>Template:Cite journal</ref>
Challis summarized 741 cases between 1900 and 1987<ref name="Challis"/>
O'Regan Brendan, Carlyle Hirschberg collected over 3,500 references from the medical literature<ref>Template:Cite book</ref>
Hobohm, in a meta-analysis, investigated about 1000 cases<ref name="Hobohm1"/>
Turner, in a qualitative research study, conducted interviews with 20 patients with spontaneous remissions<ref>Template:Cite thesis</ref>
Surviving Against All Odds - re sole survivor in "a gamma interferon study"<ref>Template:Cite magazine</ref><ref>Template:Cite book</ref>

ReferencesEdit

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External linksEdit

Spontaneous remissions and an immunological explanation