What is Treatable but not Curable cancer?

There has been a lot of discussion around the terminology that is used for patients with incurable or metastatic cancer – as sometimes incurable patients do not have metastatic disease. Equally, not all metastatic patients are incurable. As such, you may see terminology used including the following terms:

  • Metastatic (Metastasis or metastatic disease is the spread of cancer from one part of the body to another – (National Disease Registration Service. (2023). Data. [Online]. National Disease Registration Service. Available at: https://digital.nhs.uk/ndrs [Accessed 3 September 2024].)
  • Incurable
  • Secondary/secondaries
  • Terminal
  • Palliative 
  • Best Supportive Care

Some people will have treatable but not curable cancer from the moment they are diagnosed. Others develop it if their cancer progresses or comes back.

While not curable, these cancers are generally considered treatable if treatments are available that could be used to slow the progression of the cancer and help people to manage their symptoms.

Advances in treatment and care mean people can now live for several years with treatable but not curable cancer. Some people will live for many years. In some cases, it may at times feel like living with a long-term condition such as multiple sclerosis or type 1 diabetes. (National Disease Registration Service. (2023). Data. [Online]. National Disease Registration Service. Available at: https://digital.nhs.uk/ndrs [Accessed 3 September 2024].)

Patients can present with metastatic disease with either a new primary, progression or recurrence.

 

What Is Recurrence?

Cancer recurrence can be defined as the return of cancer after treatment and after a period of time during which the cancer cannot be detected. The length of time is not clearly defined; however, the patient would have previously been informed that they are free of the disease or that the disease is not detectable. The same cancer may come back where it first started or somewhere else in the body. For haematological malignancies, recurrence may be more commonly referred to as a relapse.

 

What are the types of recurrence?

The distinction between the types of recurrence of a previously treated tumour requires clinical interpretation. There are different types of cancer recurrence, for example: local recurrence - meaning that the cancer has come back in the same place it first started regional recurrence - meaning that the cancer has come back in the lymph nodes near the place it started distant recurrence - meaning the cancer has come back in another part of the body, some distance from where it started (often the lungs, liver, bone marrow, or brain)

What does the data say?

What does the data sayCancer Incident rates in UK:

There are more than 385,000 new cancer cases in the UK every year, that’s more than 1,000 every day (2017-2019)

  • Every two minutes someone in the UK is diagnosed with cancer
  • There are around 167,000 cancer deaths in the UK every year, that’s nearly 460 every day (2017-2019)
  • Lung, bowel, breast and prostate cancers together accounted for almost half (45%) of all cancer deaths in the UK in 2017-2019
  • Half (50%) of people diagnosed with cancer in England and Wales survive their disease for ten years or more (2010-11)

Cancer research UK. (2019). Cancer incidence statistics. 

The latest Cancer Alliance Research shows that in 2019, 2045 patients were diagnosed with cancer at St Helens and Knowsley (STHK, now part of Mersey and West Lancashire Teaching Hospitals). Of those diagnosed, 601 patients (29%) were diagnosed with a metastatic / treatable but not curable cancer at first presentation