Healthcare providers use many terms to describe the progress of a cancer or its response to treatment. The term "progressive disease" describes cancer that is growing, progressing, or worsening.
There are many reasons why cancer could be labeled as being progressive, and your prognosis may vary significantly depending on which underlying process is at play. It's also important to note that with new available treatments, progressive disease is not always a sign that a treatment is not working.
![Illustration of cancer cells associated with progressive disease](https://www.verywellhealth.com/thmb/QvIsAKSRsBlls0rX7TIbaKOxpn8=/1500x0/filters:no_upscale():max_bytes(150000):strip_icc():format(webp)/iStock_000073573045_Large-565d22503df78c6ddf714e44.jpg)
What Is Progressive Disease?
With cancer, progressive disease is defined as at least a 20% growth in the size of the tumor or spread of the cancer since the beginning of treatment. You may also be told you have progressive disease if the size of your primary tumor has not changed significantly, but you have new metastases (when cancer spreads from its original location to another area of the body).
Historical Meaning of Progressive Disease
If you have been told you have progressive disease, it can mean one of two things:
The Tumor Is Growing
As noted, an increase of 20% in tumor size is considered a progressive disease. Keep in mind that measurements determining the increase in tumor size are approximations, and may not be exact.
A tumor classified as being progressive has likely grown substantially or it would be called a stable disease.
The Tumor Is Spreading
Your tumor has spread to new regions or there is more evidence of cancer seen in any area of previous spread.
Why Progressive Disease May Not Mean Treatment Failure
The criteria for progression are changing. While having progressive disease previously meant one of the two situations above, this may no longer be the case.
An example is with immunotherapy medications. Rarely do people who have good responses to immunotherapy drugs initially appear to have progressive disease. The term that is used to describe this situation is "pseudoprogression" or the appearance of progression when a tumor has not actually progressed.
Imaging studies may indicate that a tumor appears larger or has spread to new regions. When biopsies are done, however, the apparent increase in size of the tumor is actually due to the presence of cancer-attacking lymphocytes (certain white blood cells involved with immune support) surrounding the tumor.
In some cases, the tumor is no longer present at all. The same situation may also occur with metastases.
A tumor that could not previously be seen in an imaging study may appear because of the presence of immune cells.
This means that it's important to talk to your oncologist if you've been told that you have a progressive disease and discuss your best treatment plan.
Next Steps
Your healthcare provider may use the term "progressive disease" as an indicator of when to choose a new treatment. For example, it may be time to switch to a second-line treatment instead of continuing the first-line treatment. The term may also be used as part of a clinical trial to indicate an inadequate or poor response to an experimental treatment.
The life expectancy of people with progressive cancer depends on different factors: age, the type, stage, and location of cancer, overall health, treatment type, and how well the cancer responds to treatment.
However, it's important to note that survival rates are estimates and don't indicate how well someone will respond to treatment.
Other Terms Describing the Current State of a Cancer
There are several other terms that you may hear in reference to your cancer:
Stable Disease
Stable disease means that the cancer hasn't changed significantly in either direction. In other words, it hasn't grown significantly or decreased significantly in size. Stable disease can be a positive sign during treatment. Generally, a tumor would be expected to continue growing. If it hasn't grown, it can mean the treatment is working.
Complete Response
If you have a complete response, it means that all detectable signs of a tumor are gone. This may also be called a complete remission or no evidence of disease (NED).
In a complete response, there will be no indication of cancer present on a physical exam or imaging studies such as a computed tomography (CT) scan, magnetic resonance imaging (MRI), or positron-emission tomography (PET) scan for at least one month.
It does not mean that cancer is cured, as there may still be microscopic cells and regions of cells that are not detectable with current imaging or testing abilities.
Partial Response
A partial response means that a tumor has decreased in size by at least 50% for at least one month, but there is still detectable disease present. This may also be referred to as a partial remission. As with complete remission, there is no way to indicate how long a remission will last.
Objective Response
The term "objective response" most often refers to either a partial response or a complete response to a treatment.
Clinical Benefit
"Clinical benefit" is an informal term referring to a situation where, as long as the cancer is prevented from getting worse, the patient is benefiting. It does not mean a patient has had a response; rather, they have derived a benefit because the cancer has not gotten worse.
Some cancers progress more rapidly than others. These cancers are often diagnosed late and can be difficult to treat: lung, pancreatic, ovarian, triple-negative breast cancer, and glioblastoma multiforme (a type of brain cancer).
Summary
If you've learned you have progressive disease, you may be feeling depressed. However, it does not mean that there are no options left.
When a cancer or tumor becomes resistant to treatment, it doesn't mean the cancer is untreatable. It may only indicate that it's time to switch to another line of treatment, which will hopefully be more effective.
Certain cancers may progress more quickly than others, but it's important to note that survival rates are only estimates. Consult with your healthcare provider to discuss your progressive disease and to determine the best treatment plan for you.