Spontaneous remission

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As spontaneous remission , even spontaneous regression named in the will Oncology (ie with cancer ) unexpectedly entering improvement or recovery ( healing ), respectively. Everson and Cole gave the following definition of spontaneous remissions in their 1966 book: Spontaneous remission is the complete or partial disappearance of a malignant tumor in the absence of all treatments or with treatments for which no proof of efficacy has yet been established. In the case of cancers of the hematopoietic system one speaks of spontaneous remission, in solid tumors of spontaneous regression; however, these two terms are often used synonymously. Both are forms of spontaneous healing in cancer.

frequency

It has long been assumed that spontaneous remissions are a rare phenomenon in cancer and that they increase in certain forms of cancer and are rare in other forms of cancer (more common in malignant melanoma , renal cell carcinoma , malignant lymphoma and neuroblastoma in children , less often in bronchial and breast cancer, colorectal cancer , invasive cervical carcinoma , gastric or ovarian carcinoma and acute leukemia). In a review article, a frequency of 1 / 100,000 cancers was estimated, although this value can vary significantly up or down in reality. On the one hand, not all spontaneous remissions are recorded, either because the case was not well documented, because the treating doctors did not publish the case or because the patient in question simply did not return to the clinic. On the other hand, hardly any cancer patient has been untreated for 100 years, so the influence of the respective treatment is unclear. Nevertheless, spontaneous healing in cancer is undoubtedly a real phenomenon, for which one can find over 1000 published case studies in the PubMed literature database.

It is possible, however, that the frequency of spontaneous regressions, at least in the case of small tumors, is significantly higher than previously assumed. In a mammography study from 2008, a 22% lower cumulative incidence of breast cancer was found in the control group without mammography compared to the group with mammography; this finding was discussed in detail in the paper and ultimately interpreted as a spontaneous cure rate of 22% in breast cancer, a value that was also found in a paper from 2006.

causes

In medical circles, the cause of spontaneous remissions in cancer is often programmed cell death ( apoptosis ) or the inhibition of angiogenesis (new blood vessels) in tumors. But neither apoptosis nor angiogenesis are causes, but biological mechanisms at the cellular level, which in turn need a trigger. In many cancer cells, apoptosis is switched off by mutations, and angiogenesis is switched on by mutations; Cancer exists because these two mechanisms are no longer working properly. A large number, if not a large number, of spontaneous regressions in cancer appear to be closely related in time to violent febrile infections. If this temporal coincidence should be a causal connection, febrile infections should also be noticeable preventively (prophylactically), i. H. reduce the risk of developing cancer. This assumption was supported by the amalgamation of more than 30 epidemiological studies.

Review article

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

literature

Web links

Individual evidence

  1. ^ WH Cole, TC Everson: Spontaneous Regression of Cancer . WB Saunders, Philadelphia, PA. 1966, OCLC 1290804
  2. ↑ a b Siegfried Hoc: Spontaneous remissions: a real, but rare phenomenon. In: Deutsches Ärzteblatt 102, issue 46 of November 18, 2005, page A-3162 / B-2671 / C-2501
  3. ↑ a b U. Hobohm: Fever and cancer in perspective (PDF; 86 kB), In: Cancer Immunol Immunother 50, 2001, pp. 391-396 doi: 10.1007 / s002620100216
  4. ^ Per-Henrik Zahl, Jan Mæhlen, H. Gilbert Welch: The Natural History of Invasive Breast Cancers Detected by Screening Mammography. In: Arch Intern Med. Vol 168 (NO. 21), Nov 24, 2008, pp. 2311-2316.
  5. ↑ DG Fryback, NK Stout, MA Rosenberg, A. Trentham-Dietz, V. Kuruchittham, PL Remington: The Wisconsin breast cancer epidemiology simulation model. In: J Natl Cancer Inst Monogr. 36 (36), 2006, pp. 37-47.
  6. ^ Robert A. Weinberg: The Biology of Cancer. Garland Science, 2007.
  7. ↑ U. Hobohm: Fever therapy revisited (PDF; 90 kB). In: British Journal of Cancer . 92, 2005, pp. 421-425.
  8. ↑ C. Maletzki, M. Linnebacher, R. Savai, U. Hobohm: Mistletoe lectin has a shiga toxin-like structure and should be combined with other Toll-like receptor ligands in cancer. Cancer Immunol Immunother. 62, 2013, pp. 1283-1292.
  9. ↑ Rohdenburg: Fluctuations in the growth of tumors energy in one, with esspecial reference to spontaneous recession. In: J Cancer Res. 3, 1918, pp. 193-225.
  10. ^ J. Fauvet: Spontaneous cancer cures and regressions. In: Rev Prat. 14, 11 Jun 1964, pp. 2177-2180.
  11. ^ W. Boyd: The spontaneous regression of cancer. Charles Thomas, publ., Springfield Ill. 1966, OCLC 2668338
  12. ^ WH Cole: Spontaneous regression of cancer and the importance of finding its cause. In: Natl Cancer Inst Monogr. 44, Nov 1976, pp. 5-9. PMID 799760
  13. ^ WH Cole, TC Everson: Spontaneous Regression of Cancer. WB Saunders, Philadelphia, PA. 1966, OCLC 1290804
  14. ^ Everson, Cole: Spontaneous Regression of Cancer: Preliminary Report. In: Ann Surg . 144 (3), September 1956, pp. 366-380. PMID 13363274 , PMC 1465423 (free full text)
  15. ^ GB Challis, HJ Stam: The spontaneous regression of cancer. A review of cases from 1900 to 1987. In: Acta Oncol . 29 (5), 1990, pp. 545-550. PMID 2206563
  16. ^ O'Regan Brendan, Carlyle Hirschberg: Spontaneous Remission. An Annotated Bibliography. Institute of Noetic Sciences. Sausalito, California 1993, ISBN 0-943951-17-8 .