What Does Remission Really Mean?

A Plain-Language Guide to Cancer Terms Like NED, Stable Disease, and Response

Recently I saw one of my patients, a 56-year-old woman living with metastatic clear cell kidney cancer.

She’s been on a combination of pembrolizumab (an immunotherapy) and cabozantinib (a targeted therapy), and she’s responded beautifully. The cancer that had spread to her lungs is no longer visible on scans. She's feeling well, working full time, and staying active. Aside from some GI side effects that improved after a dose adjustment, her quality of life is high.

During a recent visit, she asked me a question I hear often:

“If my cancer is gone, why am I still on treatment?”

It’s a fair question. And an important one.

More people are now living well with advanced cancer. Some reach a point where their scans look completely clear. But that doesn’t always mean we stop treatment. In many cases, it’s the treatment that is keeping things that way.

These conversations go beyond what shows up on imaging. They touch upon something deeper. Words like NED, remission, stable, and progression appear in MyChart, in office visits, and in clinic notes. But they also carry emotional weight. Patients bring these words home to their friends and family. And they often wonder what they really mean for the future.

So let’s go through them together. Here’s how I use these terms in clinic, what they mean in plain language, and how they help guide decisions for patients.

Photo by National Cancer Institute on Unsplash

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No Evidence of Disease (NED)

This means that right now, using all the tools we have—scans, bloodwork, and a careful physical exam — we see no signs of cancer. It is one of the best things I get to say. NED describes what we see today, but it is not a guarantee for the future.

Remission

Remission means the cancer is under control and undetectable for a period of time.

• Complete remission means no visible cancer.

• Partial remission means the cancer has shrunk in a meaningful way but is still present.

People often use NED and remission interchangeably. I explain it this way: NED is more of a snapshot, while remission refers to a stretch of time. Both are considered very good news.

Cure

Cure is a word filled with hope, but in cancer care it comes with an important reality check. We use it when we believe the cancer is gone for good and the chances of it coming back are very low. Even then, we can never give an absolute promise. How long it takes before we feel confident using the word depends on the type of cancer. For some, that may be five years without recurrence. For others, the window is shorter or longer. Each clear scan, each good lab result, and each healthy year that passes builds our confidence in using this word.

Stable Disease

The cancer hasn’t changed much since the last scan. No meaningful growth, no meaningful shrinkage. This might sound like bad news, but in some cases, stability is a success, especially when the cancer would otherwise be growing or spreading.

Progression

The cancer has grown, spread, or shown up somewhere new. When that happens, we look at the full picture, scans, symptoms, labs, and sometimes confirm with another test before making a decision to change treatment.

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How Well Is Treatment Working?

Here’s how we typically describe treatment response:

• Complete response – all visible cancer is gone

• Partial response – the cancer has shrunk significantly (usually by at least 30 percent)

• Stable disease – not enough change to call it shrinking or growing

• Progressive disease – cancer has grown or new spots have appeared

I often summarize it like this: The cancer is gone, smaller, stable, or growing.

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How Deep Are We Looking?

Technology now allows us to go beyond scans and labs. One newer tool looks for tiny fragments of tumor DNA in the blood. You may hear this called circulating tumor DNA (ctDNA) or Minimal Residual Disease (MRD).

• MRD-negative means we don’t detect any tumor DNA in the blood.

• MRD-positive means we do, suggesting small amounts of cancer may still be active.

These tests do not replace scans or exams. I use them when the result could help guide a decision. If it would just add uncertainty without changing the plan, I leave it out.

MRD is a tool, not a final answer. Like everything else, it works best when interpreted in context, and includes your scans, labs, symptoms, and how you're feeling.

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What Are We Aiming For?

Before we start treatment, we always talk about the goals. This shapes every decision including what path we choose, how long we continue, and how we measure success.

Curative Intent

We are aiming to eliminate the cancer and give you a long, cancer-free life.

Palliative Intent

The goal is control, not cure. We want to manage symptoms, limit spread, and preserve your quality of life.

Adjuvant Therapy

Treatment given after surgery, to clean up any microscopic cells that might still be hiding.

Neoadjuvant Therapy

Treatment given before surgery, to shrink a tumor or address early spread.

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Living Well with Metastatic Disease

Back to my patient. She is doing great and her scans are clear. But she is still on treatment. Why?

In metastatic cancer, even when things look good, treatment is often what holds it all in place. We call this disease control. When that control lasts, we might describe it as a durable remission, even if treatment continues.

Remission in metastatic disease may not mean cured. But it can still be real, meaningful, and long-lasting for many patients.

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Final Thought

You deserve clear answers and a plan that fits your life, not just your diagnosis. If something doesn’t make sense, ask your oncologist. If a word feels wrong to you, its ok to say so. And when the news is good, take it in. That moment is yours.

Special thanks to Jenny Peterson and Becks for bringing forward this important topic