When Cancer is Detected Late: Is Remission Possible?
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For a long time, cancer at advanced stages was associated with a diagnosis that virtually excluded the possibility of recovery. However, the development of medicine and innovative treatment methods are opening new perspectives for patients, even at stages 3-4 of the disease. The complexity of treating cancer at later stages is associated with the spread of the tumor, the presence of metastases, and the general exhaustion of the body. Nonetheless, modern technologies not only allow for prolonging patients’ lives but also achieving sustained remission in some cases.
Several factors play a key role in the success of treatment: the genetic and molecular characteristics of the tumor, the accuracy of diagnosis, and the personalized selection of therapeutic regimens. Let’s examine how these elements affect the fight against cancer and which advancements in modern oncology offer hope for positive outcomes even in advanced forms of the disease.
Factors Affecting the Success of Cancer Treatment at Late Stages
DNA Sequencing of Malignant Tumors
One of the major revolutions in oncology has been the study of the genetics and molecular characteristics of tumors. Every malignancy is unique: its behavior, rate of growth, metastatic potential, and sensitivity to therapy depend on numerous factors.
In modern cancer diagnosis protocols, genetic testing of the tumor has become a mandatory step. It’s akin to deciphering the “instructions” of the tumor itself: what mutations are present in its genes and how do they affect its development? For example, in lung cancer, mutations in the EGFR gene are often detected, while in breast cancer, changes in the HER2 gene are observed. These discoveries have completely altered the approach to treatment.
Why is this important? Previously, cancer was treated based on its location: if the tumor was in the lung, it was treated as lung cancer. Now, we know that two different patients with the same diagnosis may require entirely different therapies. If a tumor has a specific mutation, the doctor will prescribe a targeted drug—one that specifically blocks the processes supporting the tumor to grow and spread.
The genetic characteristics of the tumor also assist in predicting treatment outcomes. For instance, in breast cancer, the presence of a HER2 mutation enables the use of monoclonal antibodies like trastuzumab, which block signals that stimulate tumor growth. This can lead to significant improvements in prognosis even at late stages.
Tumor Diagnosis: Methods for Visualizing Cancer Progression
In addition to genetic analysis, other key methods are used in cancer diagnostics. For example, liquid biopsy allows the detection of circulating tumor cells or their fragments in the blood. This is particularly important in metastatic cancer, where it’s crucial to precisely determine the extent of disease spread.
When the tumor is located in hard-to-reach areas, such as the lungs or gastrointestinal organs, doctors use optical biopsy (laser endomicroscopy). This technology uses a laser to visualize cells and tissues under a microscope during the procedure, without the need for cuts or tissue sampling.
The use of PET-CT and MRI with contrast allows not only high-precision visualization of the tumor but also an assessment of its metabolic activity (glucose consumption or other metabolite intensities), vascularization (blood supply levels), and spread (presence of metastases or local invasion into neighboring tissues).
The results of these diagnostic methods form the basis for developing a personalized treatment plan.
Types of Cancer that Respond Well to Treatment at Late Stages
Among many types of cancer, some forms demonstrate high sensitivity to therapy even at later stages. This is due not only to their biological characteristics but also to modern scientific advancements. Tumors with high mitotic activity (cell division rate) generally respond better to chemotherapy, as drugs effectively destroy rapidly dividing cells. Moreover, a number of malignant processes are driven by clearly identifiable genetic mutations that have become targets for targeted drugs. Let’s look at examples of such diseases.
Testicular Cancer
This is one of the most treatable malignancies even at advanced stages. Testicular cancer is highly aggressive and has a rapid ability to metastasize, particularly to lymph nodes and the lungs. However, due to its high sensitivity to chemotherapy (e.g., the BEP regimen: bleomycin, etoposide, cisplatin), complete remission can be achieved in more than 80% of patients.
Chronic Myeloid Leukemia (CML)
This blood-forming tumor caused by a mutation in the BCR-ABL gene leads to the uncontrolled division of blood cells. The danger of CML lies in its chronic course, which can progress to a blast crisis phase—similar to acute leukemia. A breakthrough in treatment was the discovery of tyrosine kinase inhibitors (e.g., imatinib), which precisely block the pathological processes caused by the mutation. Patients with this diagnosis now have a chance at prolonged remission and a full life.
Hodgkin’s Lymphoma
This tumor of the lymphatic system, often affecting young people, is characterized by rapid progression. Its insidious nature lies in its ability to mimic infectious diseases at early stages. However, Hodgkin’s lymphoma is extremely sensitive to chemotherapy and radiotherapy. Modern treatment regimens such as ABVD (adriamycin, bleomycin, vinblastine, dacarbazine), as well as the use of the targeted drug brentuximab vedotin, allow for remission in more than 90% of patients with limited-stage disease.
Thyroid Cancer (Medullary and Papillary)
Papillary thyroid cancer grows slowly and has a relatively favorable prognosis but can metastasize to regional lymph nodes and the lungs. Medullary cancer is more aggressive, often associated with hereditary syndromes (e.g., MEN2). Thanks to radioiodine therapy, surgical methods, and modern targeted drugs, the disease can be effectively controlled even in the presence of metastases.
Prostate Cancer
This is one of the most common cancers in men. Its feature is a prolonged asymptomatic course, which often leads to diagnosis at later stages. The main threats are metastases to the bones and internal organs. Hormonal therapy, combined with chemotherapy and innovative targeted drugs, not only slows disease progression but significantly improves the patient’s quality of life.
Certain Types of Breast Cancer (HER2+ or Hormone-Receptor Positive)
HER2+ tumors are characterized by aggressive growth and early metastasis. However, modern drugs such as trastuzumab and pertuzumab, in combination with chemotherapy and hormone therapy, offer significant therapeutic success even at later stages.
Stomach Cancer
This type of cancer is highly heterogeneous (variety of cells within one tumor), making its treatment especially challenging. Cancer cells may differ in structure, genetic characteristics, and behavior, complicating treatment since the same drug may be effective against some cells but not others. At later stages, the disease may be accompanied by massive metastasis to the liver, lungs, and peritoneum. The use of targeted therapy, such as trastuzumab for HER2+ tumors, as well as immunotherapy with nivolumab, opens up new possibilities. Some patients are able to achieve stable remission or significantly slow progression.
Hospitality Medservice collaborates with leading medical centers where personalized approaches to treating late-stage cancer are developed, considering molecular analysis of the tumor and the patient’s individual characteristics. This approach allows for the use of targeted drugs that aim to destroy malignant cells, minimizing the risk of side effects and increasing the effectiveness of treatment. In addition to the primary treatment, supportive therapy is always prescribed, focusing on stabilizing the patient’s condition, reducing treatment toxicity, and improving overall well-being. Choosing a clinic with such capabilities gives patients at late stages of cancer the best chances for extended life and improved quality of life.
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The text has been verified
Verified by: Marianna Sharipova, Certified Physician, Medical Director of HMS, with 20 years of experience in medical tourism.
Author: Anna Kukarkina, MD