What does remission mean for Kidney Cancer and how is it monitored

Understanding Remission in Kidney Cancer

What Remission Means

Remission in kidney cancer refers to a state where the cancer is no longer detectable or has significantly decreased. However, it's important to understand that remission has different levels:

Complete Remission: All signs and symptoms of cancer have disappeared based on imaging and blood tests. However, this doesn't necessarily mean the cancer is completely gone at the cellular level.

Partial Remission: The tumor has shrunk by a certain percentage (typically 30% or more), but some cancer remains visible on scans.

No Evidence of Disease (NED): Sometimes used interchangeably with complete remission, meaning no cancer can be detected by current testing methods.

How Remission is Monitored

According to the webinar on "Novel Testing to Guide Personalized Cancer Treatment," monitoring remission involves looking beyond just tumor numbers. Here's what your care team typically tracks:

Standard Imaging Monitoring

• CT scans or MRI: Usually performed every 3 months initially, then at longer intervals if stable
• PET scans: May be used to detect metabolic activity in remaining lesions
• Your oncologist will compare current images to previous ones to assess whether the tumor is stable, shrinking, or growing

Blood Tests

• Kidney function tests: Creatinine and BUN levels (important since you have kidney cancer)
• Hemoglobin and other blood counts: To monitor for anemia or other treatment side effects
• Tumor markers: Though kidney cancer doesn't have a specific marker like PSA in prostate cancer, some labs may track other indicators

Advanced Monitoring Approaches

The webinar on liquid biopsies discusses emerging blood-based monitoring methods that may become more common:

• Circulating Tumor Cells (CTCs): Blood tests that detect cancer cells circulating in your bloodstream
• Cell-free DNA (cfDNA): DNA fragments from cancer cells in your blood that can indicate disease activity
• These tests can sometimes detect recurrence earlier than imaging alone

According to the RGCC webinar on personalized cancer treatment, remission monitoring should include attention to:

• Phenotype markers (specific characteristics of remaining cancer cells)
• Tumor stem cell markers - these are particularly important because they can drive disease recurrence even when overall cell counts are low
• Regular monitoring (often annually once in remission) to catch any early signs of reactivation

Important Considerations for Kidney Cancer Patients

Monitoring Schedule: After achieving remission, your oncologist will typically:

• Start with frequent scans (every 3 months)
• Gradually space them out (every 6 months, then annually) if you remain stable
• Adjust based on your specific situation and risk factors

Why Ongoing Monitoring Matters: Even in remission, kidney cancer can recur. Some patients may have dormant cancer cells that reactivate months or years later, which is why long-term follow-up is essential.

Questions to Ask Your Kidney Cancer Team:

1. What specific imaging schedule will you use to monitor my remission?
2. Are there blood tests or liquid biopsies that could help detect recurrence earlier?
3. How often should I have follow-up appointments?
4. What symptoms should I report immediately between scheduled visits?
5. Are there any emerging tests (like CTC or cfDNA testing) that might be appropriate for my case?

The Bottom Line

Remission is an important milestone, but kidney cancer requires vigilant, long-term monitoring. Your care team will use a combination of imaging, blood work, and potentially newer blood-based tests to ensure early detection of any recurrence. The goal is to catch any changes as early as possible when treatment options are most effective.

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This information is for educational purposes only. Always consult your healthcare team for personalized medical advice and decisions.