Who has experienced a medical miracle

Spontaneous remissions: a real but rare phenomenon

MEDICAL REPORT

Defensive struggle of the human body: T-lymphocytes (orange) attack a tumor cell. The purple vesicles are an indication that programmed cell death has been initiated. Photo: Dr. Andrejs Liepins / Science Photo Library
The German Cancer Society sheds light on the topic of "Medical miracles in oncology" at a seminar.

Every oncologist is familiar with the spontaneous regression of malignant tumors. Many of the underlying processes are not yet clear. The scientifically oriented doctor will - in contrast to some patients - still not speak of a miracle. In order to approach the topic, it must first be clarified what healing actually means in oncology. According to Prof. Dr. med. Christian Peschel (Klinikum rechts der Isar, Munich) can only be said to be cured when the last carcinoma cell in the body has been killed. Even when all detectable tumor manifestations have been eliminated, one can only speak of a remission, which can then possibly last for many years.
Spontaneous remission (SR) is used when a regression of relevant activity characteristics of a malignant disease has occurred either without any therapy or under measures that, according to oncological experience, do not lead to this. In the latter case, differentiating an SR from a rare treatment success can be very difficult or impossible. Peschel recalled that spectacular therapeutic successes are now being achieved with some tumor diseases that would have been classified as “miracles” just a few years ago.
There are also examples of this in the history of medicine: Dr. med. Herbert W. Kappauf (Starnberg) reported about a young monk who, according to tradition, experienced healing of a "cancerous ulcer" in his foot at the end of the 13th century and who then lived to be 80 years old as a saint. Today he is venerated in the Catholic Church under the name of St. Peregrinus as the patron saint of cancer patients. Some diagnoses in such historical reports must certainly be questioned, but even today medical journals repeatedly report on very precisely documented SR. At most, however, there is a spontaneous remission for every 60,000 to 100,000 malignant patients. The number of unreported cases is certainly very high. Spontaneous remissions are extremely rare in common tumors, such as bronchial, gastric and colon carcinomas, but somewhat more common in some rarer tumors in relative terms.
These are, for example, malignant melanomas, renal cell carcinomas, malignant lymphomas and neuroblastomas in children. "These malignancies account for more than 50 percent of spontaneous remissions," explained Kappauf and also provides an explanation for this. “For a long time, no specific therapies were available for these tumor entities. A treatment attempt was therefore usually compared in studies with a control group without any therapy at all. Spontaneous remissions could stand out so well.
For malignant melanomas that have already metastasized, the incidence of a fully regressed primary tumor is given as up to 15 percent, while the metastases themselves regress spontaneously in a maximum of 0.27 percent. Metastases from surgically removed renal cell carcinoma regress in no more than eight percent of cases, with SR affecting lung metastases in 90 percent. In general, metastases are more stubborn than the primary tumor. Kappauf recalled CUP (cancer of unknown primary). Metastases are found in the body without being able to detect a primary tumor - not even when the deceased is autopsy.
In highly malignant non-Hodgkin lymphoma (NHL), SR is rare. In low-grade NHL, on the other hand, they occur with a frequency of around nine to 23 percent. Neuroblastomas in children appear in various types of manifestation. Almost ten percent manifest themselves in stage IVS. With this type there is almost always an SR.
Case reports of SR are very rare in bronchial and breast cancer, colorectal cancer, invasive cervical cancer, gastric or ovarian cancer and acute leukemia. These striking differences in the frequency of SR are certainly due to immunological processes and mechanisms that induce apoptosis. Hormonal influences also play a role.
Kappauf named the inhibition of angiogenesis as a very important factor. Solid tumors can only thrive if blood vessels sprout into them and ensure the supply of nutrients. Different proteins control these processes. If a tumor cannot be completely removed surgically, factors that inhibit angiogenesis can evidently predominate in the remaining tumor tissue. The tumor dies. This process is rare, but most often SR of solid tumors is preceded by surgery with incomplete tumor removal.
In particular, sensational media reports on unexpected cancer cures attribute certain personality traits, behaviors and psychospiritual factors to the patient's recovery. In fact, some cases of SR that have been associated with a religious background and deep piety are well documented. Whether this is a causal or accidental association remains unanswered.
What is certain is that psychosocial factors play a major role in the behavior, coping and quality of life of cancer patients. An “existential transformation” can be triggered through which the patient discovers “being” or God. He is then grateful for his illness, and this attitude sets in motion psychoimmunological mechanisms that can promote SR.
Dr. med. Lothar Böning (Munich) presented two extraordinary and difficult to explain patient fates. One patient suffered from bronchial carcinoma, the other from malignant melanoma. In both cases, multiple metastases had affected different vital organs. For the first patient, only palliative treatment was possible. Without any further medical therapy, all tumors regressed and the patient lived without a tumor for another ten years. He died of a pulmonary embolism.
The melanoma patient was present in person. The primary tumor was surgically removed and the metastases underwent chemotherapy. Brain metastases were treated with radiation therapy. In addition, the patient started an alternative therapy (BCG vaccination and echinacin drops) and switched his diet to whole foods and minimal meat consumption. All tumor locations disappeared within three years. The man has lived tumor-free since 1986.
People who have had unexpected recovery like to relate this to their own efforts. International study groups have been collecting all available data for a number of years; in Germany, for example, groups from the Nuremberg Clinic and Heidelberg University Clinic. Your sobering message: With today's knowledge, there are no recommendations on how to promote spontaneous remission. Siegfried Hoc


Patient congress: "Medical miracles in oncology" of the German Cancer Society e.V., Frankfurt / Main, in Munich
Spontaneous remissions: a real but rare phenomenon

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