Spontaneous remission

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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. [1] 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.

Contents

Definition

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." [2]

Frequency of spontaneous regression in cancer

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; [3] 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. [4]

Causes

Everson and Cole offered as explanation for spontaneous regression from cancer:

In many of the collected cases [...] it must be acknowledged that the factors or mechanisms responsible for spontaneous regression are obscure or unknown in the light of present knowledge. However, in some of the cases, available knowledge permits one to infer that hormonal influences probably were important. [...] In other cases, the protocols strongly suggest that an immune mechanism was responsible. [2]

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." [5]

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. [6]

There are several case reports of spontaneous regressions from cancer occurring after a fever brought on by infection, [3] [7] 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. [8] [9]

Reviews

Related Research Articles

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An angiogenesis inhibitor is a substance that inhibits the growth of new blood vessels (angiogenesis). Some angiogenesis inhibitors are endogenous and a normal part of the body's control and others are obtained exogenously through pharmaceutical drugs or diet.

<span class="mw-page-title-main">William Coley</span> American surgeon and cancer researcher

William Bradley Coley was an American bone surgeon and cancer researcher best known for his early contributions to the study of cancer immunotherapy, specifically causing infection as a way to fight cancer, a practice used as far back as 1550 BC. His work was not proven effective in his lifetime, and today Coley's toxins are known to be both ineffective and potentially harmful. Coley is nevertheless recognized as the Father of Cancer Immunotherapy for his contributions to the science.

Coley's toxins is a mixture containing toxins filtered from killed bacteria of species Streptococcus pyogenes and Serratia marcescens, named after William Coley, a surgical oncologist at the Hospital for Special Surgery who developed the mixture in the late 19th century as a treatment for cancer.

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Steven A. Rosenberg is an American cancer researcher and surgeon, chief of Surgery at the National Cancer Institute in Bethesda, Maryland and a Professor of Surgery at the Uniformed Services University of Health Sciences and the George Washington University School of Medicine and Health Sciences. He pioneered the development of immunotherapy that has resulted in the first effective immunotherapies and the development of gene therapy. He is the first researcher to successfully insert foreign genes into humans.

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<span class="mw-page-title-main">PD-L1</span> Mammalian protein found in Homo sapiens

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<span class="mw-page-title-main">Michele De Palma</span> Italian biologist

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<span class="mw-page-title-main">George Coukos</span> Tumor immunologist

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<span class="mw-page-title-main">Endothelial cell anergy</span> Defense mechanism of tumors against immunity

Endothelial cell anergy is a condition during the process of angiogenesis, where endothelial cells, the cells that line the inside of blood vessels, can no longer respond to inflammatory cytokines. These cytokines are necessary to induce the expression of cell adhesion molecules to allow leukocyte infiltration from the blood into the tissue at places of inflammation, such as a tumor. This condition, which protects the tumor from the immune system, is the result of exposure to angiogenic growth factors.

References

  1. ↑ Radha G., Lopus M. (2021) The spontaneous remission of cancer: Current insights and therapeutic significance. Translational Oncology. 14 (9):101166, doi:10.1016/j.tranon.2021.101166
  2. 1 2 3 Everson T., Cole W. (1968) Spontaneous Regression of Cancer Philadelphia, JB Saunder & Co (Book)
  3. 1 2 3 Hobohm, U. (2001). "Fever and cancer in perspective". Cancer Immunology, Immunotherapy. 50 (8): 391–6. doi:10.1007/s002620100216. PMID   11726133. S2CID   109998.
  4. ↑ Zahl, P. H.; Maehlen, J.; Welch, H. G. (2008). "The natural history of invasive breast cancers detected by screening mammography". Archives of Internal Medicine. 168 (21): 2311–6. doi:10.1001/archinte.168.21.2311. PMID   19029493.
  5. 1 2 Challis, G. B.; Stam, H. J. (1990). "The spontaneous regression of cancer. A review of cases from 1900 to 1987". Acta Oncologica. 29 (5): 545–50. doi: 10.3109/02841869009090048 . PMID   2206563.
  6. ↑ Robert A. Weinberg (2007) The Biology of Cancer, Garland Science
  7. ↑ Hobohm, U. (2005). "Fever therapy revisited". British Journal of Cancer. 92 (3): 421–5. doi:10.1038/sj.bjc.6602386. PMC   2362074 . PMID   15700041.
  8. ↑ Hobohm, U.; Stanford, J. L.; Grange, J. M. (2008). "Pathogen-associated molecular pattern in cancer immunotherapy". Critical Reviews in Immunology. 28 (2): 95–107. doi:10.1615/critrevimmunol.v28.i2.10. PMID   18540826.
  9. ↑ Maletzki, C.; Linnebacher, M.; Savai, R.; Hobohm, U. (2013). "Mistletoe lectin has a shiga toxin-like structure and should be combined with other Toll-like receptor ligands in cancer therapy" (PDF). Cancer Immunology, Immunotherapy. 62 (8): 1283–92. doi:10.1007/s00262-013-1455-1. PMID   23832140. S2CID   26031460.
  10. ↑ Rohdenburg, G. L. (1 April 1918). "Fluctuations in the Growth Energy of Malignant Tumors in Man, with Especial Reference to Spontaneous Recession". The Journal of Cancer Research. 3 (2): 193–225. doi:10.1158/jcr.1918.193 (inactive 31 January 2024).{{cite journal}}: CS1 maint: DOI inactive as of January 2024 (link)
  11. ↑ Fauvet, J.; Roujeau, J.; Piet, R. (1964). "Spontaneous Cancer Cures and Regressions". La Revue du Praticien. 14: 2177–80. PMID   14157391.
  12. ↑ Boyd W: The spontaneous regression of cancer. Charles Thomas, Publ., Springfield Ill. 1966 (Book)
  13. ↑ Cole, W. H. (1976). "Spontaneous regression of cancer and the importance of finding its cause". National Cancer Institute Monograph. 44: 5–9. PMID   799760.
  14. ↑ O'Regan, Brendan; Hirschberg, Carlyle (1993). Spontaneous Remission. An Annotated Bibliography. Sausalito, California: Institute of Noetic Sciences. ISBN   978-0-943951-17-1.
  15. ↑ Turner, Kelly Ann (2010). Spontaneous Remission of Cancer: Theories from Healers, Physicians, and Cancer Survivors (Thesis). Berkeley: UC Berkeley Electronic Theses and Dissertations.
  16. ↑ Geoggrey Cowley (March 13, 1995). "Surviving Against All Odds". Newsweek . p. 63.
  17. ↑ Caryle Hirshberg; Marc Ian Barasch (1996). Remarkable Recovery. Riverhead Books. ISBN   9781573225304.

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