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   Jun 16

The cancers that spontaneously DISAPPEAR

Earliest case of spontaneous regression was late 13th century

Involved Peregrine Laziosi the ‘patron saint of cancer patients’

Theories it is due to an immune response being triggered in the body

Professor Momna Hejmadi teaches cancer biology at University of Bath

Many people who have survived cancer describe losing their hair as one of the most harrowing – and visible signs – of having the disease.

While chemotherapy and radiotherapy are often a necessary evil for the best chance of surviving the illness, the treatments are known take their toll on patients.

But there have been cases where cancer has been known to disappear all by itself.

Writing for The Conversation, Professor Momna Hejmadi, a cancer biologist at the University of Bath, explores the phenomenon.

It is hard to believe that some cancers miraculously disappear, but it does happen.

Over 1,000 case studies document cancer sufferers who experienced spontaneous regression of their tumour.

So why does this happen and is it possible to exploit it to benefit all cancer patients?

The earliest documented case of spontaneous regression was in the late 13th century.

A bone sarcoma in Peregrine Laziosi (the saint of cancer patients) spontaneously disappeared after a severe bacterial infection.

Although rare, cases where cancer spontaneously disappeared without treatment do exist. But the reasons behind the miraculous regression are so far only theories, says Professor Hejmadi

In the late 1800s, bone surgeon and cancer researcher William Coley observed that inducing a fever could result in tumour regression.

He developed a bacterial vaccine (‘Coley’s vaccine’) that was successful in reducing tumours in many of his patients.

Tumours have been known to disappear spontaneously, in the absence of any targeted treatment, usually after an infection (bacterial, viral, fungal or even protozoal).

Could this mean that simply stimulating the immune system causes regression?


Over the past 70 years, spontaneous regression has been reported in a variety of cancer types, but particularly in melanomas (skin), renal cell carcinomas (kidney), neuroblastomas (adrenal glands) and some types of blood cancers.

However, despite these historical observations of tumour regression, we still do not know the mechanisms that cause this phenomenon.

It is also very difficult to quantify, and many cases are probably unreported in research journals.

One likely reason for spontaneous regression is that the body triggers an immune response against specific antigens displayed on the surface of tumour cells.

Support for this idea comes from the observation that some skin tumours (malignant melanoma) show excessively high numbers of the body’s immune cells inside the tumour.

In another interesting case report, a patient with kidney cancer had a part of his tumour surgically removed, which resulted in the spontaneous regression of the rest of his tumour.

The rationale underlying this phenomenon is that a local immune response following surgery was enough to stop growth of the rest of the tumour.

But tumours are notoriously varied, both in their genetics and their behaviour, which can result in relentless disease progression in some people, but cause spontaneous regression in others.

Tumours of the same type (such as breast cancer) can mutate in many different ways.

This can influence the rate of tumour growth, or the likelihood of spread to different locations, or how responsive they are to treatment.

It is highly probable that genetic mutations are also responsible for spontaneous regression.


Neuroblastoma is a type of rare childhood cancer that could shed some light on how genetic changes may affect spontaneous regression.

About 100 children are diagnosed with the condition every year in the UK, but the disease progresses very differently depending on the child’s age.

Tumours in children under 18 months can disappear with or without any treatment (type 1).

But children older than 18 months need intensive treatment and have only a 40-50% survival rate (type 2).

Spontaneous regression has been reported in a variety of cancer types, but particularly in melanomas, or skin cancer (pictured), over the last 70 years

Research shows that type 1 neuroblastomas have distinctive genetics compared to type 2.

For instance, these tumours typically have high numbers of a cell receptor (TrkA) which can trigger tumour cells to kill themselves. In contrast, type 2 neuroblastomas have a higher number of a different receptor (TrKB), which makes these tumours more aggressive.

Another possible explanation is that type 1 neuroblastomas show very low levels of activity of an enzyme, telomerase, compared with type 2 tumours.

Telomerase controls the length of specialised pieces of DNA which enables the cell to divide continually.

In type 1 neuroblastomas, these are very short and unstable due to low activity of the enzyme, and this triggers cell death.

Epigenetic changes cannot be excluded either.

Epigenetic changes do not affect the DNA sequence of a cell but modify the activity of various proteins by “tagging” different parts of the DNA.

So cells with the same DNA sequence, but with different tags may behave completely differently and result in some tumours destroying themselves.

Neuroblastoma, a type of rare childhood cancer that could shed some light on how genetic changes may affect spontaneous regression, says Professor Hejmadi (file image)

Recent studies showed significant differences in tagged genes in type 1 neuroblastomas compared to type 2, although these are preliminary findings.

Although the precise mechanisms underlying spontaneous regression are still uncertain, it is very likely that stimulating a strong immune response must play a big part in people with certain genetic profiles.

Further research exploring this link between genetics and stimulating an immune response would provide answers to how we can identify tumours that have the capacity to spontaneously regress.

The next step would be to design drugs that can artificially stimulate the immune system to specifically target tumours based on their genetic makeup.

Developing animal models that mimic human spontaneous regression would be an invaluable tool towards this.

Source: Daily Mail

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