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Managing Cancer as a Chronic Illness
Cancer isn’t always a one-time event. Cancer can be closely watched and treated, but sometimes it never completely goes away. It can be a chronic (ongoing) illness, much like diabetes or heart disease. This is often the case with certain cancer types, such as ovarian cancer, chronic leukemias, and some lymphomas. Sometimes cancers that have spread or have come back in other parts of the body, like metastatic breast or prostate cancer, also become chronic cancers.
The cancer may be controlled with treatment, meaning it might seem to go away or stay the same. The cancer may not grow or spread as long as you’re getting treatment. Sometimes when treatment shrinks the cancer, you can take a break until the cancer starts to grow again. But in either of these cases the cancer is still there – it doesn’t go away and stay away – it’s not cured.
Living with cancer is different from living after cancer. And it’s becoming more common every day.
How is chronic cancer described?
A doctor may use the term controlled if tests or scans show that the cancer is not changing over time. Another way of defining control would be calling the disease stable. Cancers like this are watched closely to be sure that they don’t start growing.
The cycle of recurrence and remission
Most chronic cancers cannot be cured, but some can be controlled for months or even years. In fact, there’s always a chance that cancer will go into remission. There are different kinds of remission.
When a treatment completely gets rid of all tumors that could be measured or seen on a test, it’s called a complete response or complete remission.
A partial response or partial remission means the cancer partly responded to treatment, but still did not go away. A partial response is most often defined as at least a 50% reduction in measurable tumor. Here, when we refer to a remission it will generally mean a partial remission.
To qualify as either type of remission, the absence of tumor or reduction in the size of the tumor must last for at least one month. There’s no way to tell how long a remission will last, so remission does not mean the cancer definitely has been cured.
Some cancers (for example, ovarian), have a natural tendency of recurrence and remission. Often, this repeating cycle of growing, shrinking, and stabilizing can mean survival for many years during which the cancer can be managed as a chronic illness. Treatment can be used to control the cancer, help relieve symptoms, and help you live longer.
Progression
Cancers that aren’t changing may be called stable disease. When cancer grows, spreads, or gets worseit’s called cancer progression. When cancer comes out of remission it’s said to have progressed. In the case of chronic cancers, recurrence and progression can mean much the same thing.
Progression may be a sign that you need to start treatment again to get the cancer back into remission. If the cancer progresses during or soon after treatment, it may mean that a different treatment may be needed.
Progression and recurrence occur when the treatment doesn’t kill all of the cancer cells. Even if most of the cancer cells were killed, some were either not affected or were able to change enough to
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