The medical community uses the term NED or NOED – an acronym meaning “no evidence of disease” – when a cancer patient’s signs and symptoms are no longer detectable through diagnostic procedures. NED also means the patient is in “complete remission.”
Reaching NED status promises an optimistic future for those whose cancer diagnosis caused hopelessness among patients and their loved ones. While it does not guarantee a cancer-free life (small amounts of malignant cells may lurk in silence), the National Cancer Institute considers cancer cured if it maintains NED status for five years.
Continue reading for a comprehensive guide to NED and other terms that may describe cancer’s status.
What Is NED or Complete Remission?
Medical professionals use “NED,” “NOED,” or “complete remission” to communicate that cancer cells are no longer present in the body. Based on the disease diagnosed, the patient will undergo blood tests, biopsies, or advanced imaging tests to detect signs of cancer. To reach NED status, these tests must indicate zero signs of cancer for at least a month.
Patients celebrate achieving NED, as it indicates successful cancer treatment. It also suggests a reduced risk for metastatic cancer. Metastatic cancer is when malignant cells make their way through the blood and lymph system to invade other areas of the body. Also known as stage IV (four) cancer, it is more challenging to treat and has a poor prognosis in most cases.
Metastatic Cancer and NED Probability
In 2016, a study analyzed the outcomes of metastatic breast cancer patients who achieved NED post-treatment versus those who did not. The researchers found that those who reached NED status had a 96 percent and 78 percent overall survival rate after three and five years compared to all patients’ rates of 44 percent and 24 percent. However, only 16 percent of the participants achieved NED.
It is worth noting that achieving complete remission does not guarantee cancer eradication, as undetectable cancer cells may still exist, leading to the disease’s recurrence.
The possibility of cancer recurrence varies depending on the cancer type. For example, 30 to 55 percent of non-small cell lung cancer patients develop recurrence, according to a 2013 review article. Meanwhile, Hodgkin lymphoma has a recurrence rate of 10 to 13 percent.
NED vs. Cure
As per the National Cancer Institute, physicians consider cancer cured when all evidence of the disease is untraceable, and cancer cells are unlikely to return. However, achieving NED does not always mean cured, though it might be a step towards it. Medical professionals may consider cancer cured if the patient remains in complete remission for a minimum of five years. But due to cancer being unpredictable, recurrence may occur after five years, although the probability is lower. Most relapses, secondary cancer formation, and severe side effects manifest within three years of diagnosis.
Does Cancer Come Back After Decades in Remission?
In 2022, an extensive case study expounded on a rare instance of breast cancer recurrence after 27 years in complete remission. The study involved a 67-year-old woman who received her initial diagnosis in 1994. At the time, she had her left breast removed through a mastectomy, which proved effective. Unfortunately, her cancer re-emerged after 27 years of full recovery.
Experts warn that all cancer patients should not rule out the possibility of recurrence, even after decades of achieving NED.
Other Terms Used to Describe the Remission State of Cancer
Healthcare providers use a myriad of medical jargon to describe cancer’s status, and NOED is only one of them. Let’s explore the others.
1. Near-Complete Remission
Near-complete remission (nCR) is a term used to describe the state when the cancer has been reduced significantly but not eradicated completely. During this stage, small tumors or cancer cells may be present, but they are “on pause,” meaning no longer active or spreading.
In some cases, nCR may be the best possible outcome for a patient, especially in advanced cancer cases where complete cancer eradication may be difficult to achieve.
The term near-complete remission is not common in clinical practice. Usage may vary from one medical professional to another.
2. Partial Remission
A cancer patient is in partial remission, also called partial response, when the disease responds to treatment but is not eliminated entirely. In general, partial remission describes a reduction in tumor size by at least 50 percent. As with complete remission, doctors consider cancer in partial remission when the improved state carries on for at least a month.
Similar to nCR, partial remission may be the best possible outcome for someone with advanced cancer.
Partial remission is commonly used in clinical practice, with imaging tests such as CT scans or MRIs determining the extent of tumor shrinkage. In addition, healthcare professionals may use other criteria – including the patient’s symptoms, bloodwork results, and physical exam findings – to assess the level of disease activity.
3. Spontaneous Remission
Spontaneous remission describes the rare instance of cancer disappearing without any known intervention or treatment. In this case, cancer enters remission on its own, without any medical explanation.
Spontaneous remission is not fully understood by science and medicine. According to a 2022 analysis, the incidence rate of spontaneous cancer remission is low, occurring in only 1 in over 100,000 cancer patients. Chodorowski et al. also reported that spontaneous remission is most prevalent in patients with renal cell carcinoma, neuroblastoma, melanoma, and lymphoma.
“No Evidence of Disease” means there are no signs of cancer found in the body through various diagnostic procedures. Achieving NED is an encouraging indication that cancer treatment has been successful. Still, the possibility of cancer recurrence remains due to the disease’s unpredictable nature.
In most cases, cancer emergence happens within the first five years. While recurrence after a decade or more is rare, it can happen, as in the 2022 case study where an elderly’s breast cancer came back 27 years later. Therefore, even if you have reached NED status, continue collaborating with your medical team to monitor your health and reduce the probability of cancer recurrence.
Achieve Complete Remission Through Comprehensive Therapy
If you or someone in your social circle is battling cancer, achieving NED can be possible through comprehensive cancer therapy. Contact New Hope Unlimited today to learn more about holistic cancer treatment options and take the first step towards reclaiming your health.