Table of ContentsView AllTable of ContentsNo Evidence of Disease and Cancer RemissionMetastatic CasesWhy Cancer Isn’t CuredRecurrenceHealth Concerns
Table of ContentsView All
View All
Table of Contents
No Evidence of Disease and Cancer Remission
Metastatic Cases
Why Cancer Isn’t Cured
Recurrence
Health Concerns
No evidence of disease (NED) means the same thing as complete remission or complete response. It is the term that healthcare providers use when there is no evidence of cancer after treatment. NED does not mean that cancer is cured, though. With most cancers, there is a chance that cancer cells could one day cause a recurrence (return of cancer).
Many people rightly celebrate “being NED" after treatment. Keep in mind that even after achieving complete remission,chemotherapyandradiationcan have long-term side effects. Some people may experience ongoing stress, fear, survivor guilt, and other potential mental health impacts.
FatCamera / Getty Images
Complete remission is the same as NED. Complete remission means that there is no longer evidence of cancer in your body based on:
The National Cancer Institute definesremissionas a “decrease in or disappearance of signs and symptoms of cancer." While the term “complete remission” is used when all cancer signs and symptoms are gone, it is also possible to be in “partial remission,” where only some of the cancer signs and symptoms have disappeared.
Providers rarely use the word “cured” when describing cancer. Years or decades after treatment, you still may have somecancer cellsinside your body that could potentially allow cancer to return.
Cancer-Free vs. NEDHealthcare providers may use the term cancer-free, which is similar to NED. It means that there is no identifiable presence of cancer. It does not rule out the possibility of recurrence.
Cancer-Free vs. NED
Healthcare providers may use the term cancer-free, which is similar to NED. It means that there is no identifiable presence of cancer. It does not rule out the possibility of recurrence.
NED and Metastatic Cancer
Metastatic breast cancer typically requires lifelong treatment to control the disease. Your healthcare team will discuss different treatment options depending on the type of breast cancer you have.
Some studies demonstrate improved metastatic breast cancer survival rates in those who achieve NED status, depending on the cancer, its subtype, and the therapies used for treatment.
For example, a 2022 study of people receiving targeted therapies for metastaticHER2-positivebreast cancer suggests improved long-term outcomes in NED cases, but the variables remain under study.
After cancer treatment for metastatic breast cancer, those who establish NED generally may have longer survival times than those who do not achieve NED.
Why Cancer Is Not Called “Cured”
Healthcare providers rarely saycancer is curedwhen talking about solid tumors—even if it seems very likely your cancer will never come back. Even after treatment, it is impossible to know if there are isolated tumor cells ormicrometastases(tiny spread of cells) present in your body.
While it may be uncomfortable to think about cancer cells remaining in your body, it can be comforting to know that part of the job of your immune system is to remove damaged cells. Your immune system is constantly working to destroy or limit cancer cells.
Durable Response and What It MeansAlthough the term “durable response” is common, there is not yet a universal definition. Generally, it refers toimmunotherapy drugbenefits that persist after metastatic cancer treatment has stopped. It will be some time before experts know if these drugs provide long-term remission for people with advanced cancer.
Durable Response and What It Means
Although the term “durable response” is common, there is not yet a universal definition. Generally, it refers toimmunotherapy drugbenefits that persist after metastatic cancer treatment has stopped. It will be some time before experts know if these drugs provide long-term remission for people with advanced cancer.
Researchers knowhow breast cancer spreads, but they do not know exactly why some cancers return years later. Some cancer cells might be able to hide from the immune system or from treatment or may multiply so quickly that the immune system can’t keep up.
In some cases,adjuvanttreatments may be used to prevent the return of cancer after main treatments have been completed. Depending on subtype and other factors, more than 20 medication options approved under guideline recommendations for breast cancer include:
Recurrence and Cancer Stage
Depending on how long it has been since completing treatment, the return of cancer is classified as early recurrence orlate recurrence.
More advancedmetastaticcancers that have spread, especially estrogen receptor (ER) positive tumors, may recur at any time. In fact, ER-positive cancers have been shown to recur at any time from less than five years to more than 20 years later.
Screening for Cancer Recurrence
Physical and Mental Health Concerns
Hearing that you have achieved NED after treatment is positive news. Many people find that they face complicated feelings in this new phase of their cancer journey.
Those around you may go back to life as usual while you are coping with lingering side effects, uncertainty, and major life changes. You may experience:
If your feelings are too overwhelming or interfere with your daily life, seeking the help of a therapist may be beneficial. Your healthcare team can recommend a therapist with experience treating people who have had cancer. Lifestyle strategies that can help include:
Summary
Your healthcare team is available to help you as you move into the next phase of your life. New skills, including stress management and other lifestyle steps, can help NEDbreast cancer survivorsnavigate the changes.
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Cancer Institute.Understanding cancer prognosis.
Harvard Health Publishing.Silent suffering.
National Cancer Institute.NCI dictionary of cancer terms: remission.
MD Anderson Cancer Center.Remission, cancer-free, no evidence of disease: What’s the difference?
Veitch Z, Ribnikar D, Tilley D, Tang PA, King K, Bedard PL,et al.No evidence of disease versus residual disease in long-term responders to first-line HER2-targeted therapy for metastatic breast cancer.Br J Cancer.2022 Apr;126(6):881-888. doi: 10.1038/s41416-021-01676-4
Johns Hopkins Medicine.Overview of cancer.
National Cancer Institute.Immunotherapy to treat cancer.
Emens LA.Breast cancer immunotherapy: facts and hopes.Clin Cancer Res. 2018;24(3):511-520. doi:10.1158/1078-0432.CCR-16-3001
Breastcancer.org.Why doesn’t the immune system stop breast cancer?
Kerr AJ, Dodwell D, McGale P, Holt F, Duane F, Mannu G,et al.Adjuvant and neoadjuvant breast cancer treatments: A systematic review of their effects on mortality - PubMed (nih.gov).Cancer Treat Rev. 2022 Apr;105:102375. doi:10.1016/j.ctrv.2022.102375
Pan H, Gray R, Braybrooke J, et al.20-year risks of breast-cancer recurrence after stopping endocrine therapy at 5 years.N Engl J Med. 2017;377(19):1836-1846. doi:10.1056/NEJMoa1701830
Thewes B, Lebel S, Seguin Leclair C, Butow P.A qualitative exploration of fear of cancer recurrence (FCR) amongst Australian and Canadian breast cancer survivors.Support Care Cancer. 2016;24(5):2269-2276. doi:10.1007/s00520-015-3025-x
Schwedhelm C, Boeing H, Hoffmann G, Aleksandrova K, Schwingshackl L.Effect of diet on mortality and cancer recurrence among cancer survivors: a systematic review and meta-analysis of cohort studies.Nutr Rev. 2016;74(12):737–748. doi:10.1093/nutrit/nuw045
Trudel-Fitzgerald C, Zhou ES, Poole EM, Zhang X, Michels KB, Eliassen AH,et al.Sleep and survival among women with breast cancer: 30 years of follow-up within the Nurses' Health Study.Br J Cancer.2017 Apr 25;116(9):1239-1246. doi:10.1038/bjc.2017.85
National Cancer Institute.Study Suggests a Link between Stress and Cancer Coming Back.
Memorial Sloan Kettering Cancer Center.What is “cure”?
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
